Individual provider Active NPI

David V Eastham, MD, MPH

  • Radiation Oncology Physician
  • Travis Afb, CA
National Provider Identifier
1356412050
Registry record updated Jan 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiation Oncology PhysicianTaxonomy code 2085R0001X
License
A96202 Issued in CA
Practice address
101 Bodin Circle, SGQX
Dept of Radiation Oncology
Travis Afb, CA 94535
Phone
(707) 423-7691
NPI assigned
Nov 13, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 2, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Radiation Oncology Physician 2085R0001X A96202 CA Primary
Family Medicine Physician 207Q00000X A96202 CA

Addresses

Primary practice location

101 Bodin Circle, SGQX
Dept of Radiation Oncology
Travis Afb, CA 94535

Mailing address

101 Bodin Circle, SGQX
Dept of Radiation Oncology
Travis Afb, CA 94535
Phone (707) 423-7691

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190719000872 CA Practitioner - Radiation Oncology 7214249119 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A96202CAMDRadiation Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Northbay Healthcare Group CurrentSince May 28, 2019 Accepting new patients
Northbay Healthcare Group CurrentSince May 28, 2019 Accepting new patients

Locations

1200 B Gale Wilson Blvd
Fairfield, CA 94533
Phone (707) 429-3600

101 Bodin Cir
#Sgqx
Travis AFB, CA 94535
Phone (707) 423-7691

101 Bodin Cir
Travis AFB, CA 94535
Phone (707) 423-3000

1020 Nut Tree Rd
Ste 390
Vacaville, CA 95687
Phone (707) 624-8000

1000 Nut Tree Rd
Vacaville, CA 95687
Phone (707) 446-4000

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1163376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735776000000",
    "number": "1356412050",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 BODIN CIRCLE, SGQX",
            "address_2": "DEPT OF RADIATION ONCOLOGY",
            "city": "TRAVIS AFB",
            "state": "CA",
            "postal_code": "94535",
            "telephone_number": "707-423-7691"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 BODIN CIRCLE, SGQX",
            "address_2": "DEPT OF RADIATION ONCOLOGY",
            "city": "TRAVIS AFB",
            "state": "CA",
            "postal_code": "94535",
            "telephone_number": "707-423-7691"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EASTHAM",
        "first_name": "DAVID",
        "middle_name": "V",
        "credential": "MD, MPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-13",
        "last_updated": "2025-01-02",
        "certification_date": "2025-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "CA",
            "license": "A96202",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A96202",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Travis Afb, CA

Sources for this page

Verify at the official NPI Registry.