Organization Active NPI

Ocean Radiation Oncology Medical Assoc

  • Radiation Oncology Physician
  • Los Alamitos, CA
National Provider Identifier
1568628642
Registry record updated Jul 29, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiation Oncology PhysicianTaxonomy code 2085R0001X
License
FNP37709 Issued in CA
Legal business name
OCEAN RADIATION ONCOLOGY MEDICAL ASSOC
Practice address
3951 Katella Ave
Suite 102
Los Alamitos, CA 90720-3303
Phone
(562) 799-3198
Fax
(562) 799-3509
NPI assigned
Jul 29, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2008

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

Authorized official

Name
Dr. Robert S Kwon, M.D.
Title
President
Phone
(562) 799-3198

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Radiation Oncology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2085R0001X FNP37709 CA Primary

Addresses

Primary practice location

3951 Katella Ave
Suite 102
Los Alamitos, CA 90720-3303

Mailing address

3951 Katella Ave
Suite 102
Los Alamitos, CA 90720-3303
Phone (562) 799-3198

Other identifiers 1

IdentifierTypeStateIssuer
00A639980MedicaidCA

National Provider Directory

National Provider Directory

Locations

3951 Katella Ave
Ste 10
Los Alamitos, CA 90720
Phone (562) 799-3198

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 & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1217289600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1217289600000",
    "number": "1568628642",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3951 KATELLA AVE",
            "address_2": "SUITE 102",
            "city": "LOS ALAMITOS",
            "state": "CA",
            "postal_code": "907203303",
            "telephone_number": "562-799-3198",
            "fax_number": "562-799-3509"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3951 KATELLA AVE",
            "address_2": "SUITE 102",
            "city": "LOS ALAMITOS",
            "state": "CA",
            "postal_code": "907203303",
            "telephone_number": "562-799-3198",
            "fax_number": "562-799-3509"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OCEAN RADIATION ONCOLOGY MEDICAL ASSOC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-07-29",
        "last_updated": "2008-07-29",
        "status": "A",
        "authorized_official_last_name": "KWON",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "562-799-3198",
        "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": "FNP37709",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A639980",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Alamitos, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2008; 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.