V. Vongtama MD Inc

Primary specialty

Radiation Oncology PhysicianTaxonomy code 2085R0001X

License

A29753 Issued in CA

Legal business name

V. VONGTAMA MD INC

Doing business as

St. Teresa Comprehensive Cancer Center

Practice address

4722 Quail Lakes Dr
Stockton, CA 95207-5244

Phone

(209) 472-1848

Fax

(209) 472-0133

NPI assigned

Feb 8, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Vitune Vongtama, M.D.NPI 1598793507

Title

Owner

Phone

(209) 472-1848

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• St. Teresa Comprehensive Cancer Center Doing business as

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPDPlans: Blue Shield 65 Plus (HMO) (H0504-015-000, H0504); Blue Shield 65 Plus (HMO) (H0504-039-000, H0504); Blue Shield 65 Plus Plan 2 (HMO) (H0504-021-000, H0504); Blue Shield Inspire (HMO) (H0504-041-000, H0504); Blue Shield 65 Plus (HMO) (H0504-038-000, H0504); Blue Shield Inspire (HMO) (H0504-047-000, H0504); Blue Shield 65 Plus (HMO) (H0504-026-000, H0504); Blue Shield Advantage (HMO) (H0504-050-000, H0504); Blue Shield AdvantageOptimum Plan (HMO) (H5928-004-000, H5928); Blue Shield Inspire (HMO) (H0504-043-000, H0504)…

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Vitune Vongtama, MD

  • Radiation Oncology Physician
  • Stockton, CA
  • NPI 1598793507
  NPD Authorized official
• Jason F. Kelly, MD

  • Radiation Oncology Physician
  • Oakland, CA
  • NPI 1063590859
  NPD (past)
• Samantha A. Seaward, MD

  • Radiation Oncology Physician
  • Santa Clara, CA
  • NPI 1790862621
  NPD (past)
• Myles E Lampenfeld, MD

  • Radiation Oncology Physician
  • Erie, PA
  • NPI 1558449033
  NPD (past)

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

{
    "created_epoch": "1170892800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1408579200000",
    "number": "1386784114",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4722 QUAIL LAKES DR",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952075244",
            "telephone_number": "209-472-1848"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4722 QUAIL LAKES DR",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952075244",
            "telephone_number": "209-472-1848",
            "fax_number": "209-472-0133"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "V. VONGTAMA MD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-08",
        "last_updated": "2014-08-21",
        "status": "A",
        "authorized_official_last_name": "VONGTAMA",
        "authorized_official_first_name": "VITUNE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "209-472-1848",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2085R0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Radiology, Radiation Oncology",
            "state": "CA",
            "license": "A29753",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A297530",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "St. Teresa Comprehensive Cancer Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Radiation Oncology Physician in Stockton, CA
• Providers in Stockton, CA by specialty
• Radiation Oncology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.