NPIMap

Organization Active NPI

Memorial Radiation Oncology Medical

  • Radiation Oncology Physician
  • Fountain Valley, CA
National Provider Identifier
1639509706
Registry record updated Oct 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiation Oncology PhysicianTaxonomy code 2085R0001X
Legal business name
MEMORIAL RADIATION ONCOLOGY MEDICAL
Practice address
18111 Brookhurst St
Suite Ll0300
Fountain Valley, CA 92708-6728
Phone
(714) 962-7100
Fax
(714) 963-7600
NPI assigned
Nov 26, 2013
Last updated
Oct 15, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 15, 2025

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

Authorized official

Name
Asif R. Harsolia, MDNPI 1376565374
Title
MD/Authorized Official
Phone
(562) 492-6695

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Radiation Oncology Physician 2085R0001X CA Primary

Addresses

Primary practice location

18111 Brookhurst St
Suite Ll0300
Fountain Valley, CA 92708-6728

Mailing address

PO Box 844945
Los Angeles, CA 90084-4945
Phone (562) 492-6695

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140527000000 CA Part B Supplier - Clinic/Group Practice 6103049937 Receives reassigned benefits from 5 practitioners
2 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Fountain Valley, CA; Long Beach, CA

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Memorial Radiation Oncology Med Group2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

18111 Brookhurst St
Ste LL300
Fountain Valley, CA 92708
Phone (714) 962-7100

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1385424000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1760486400000",
    "number": "1639509706",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 844945",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900844945",
            "telephone_number": "562-492-6695",
            "fax_number": "562-988-0389"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18111 BROOKHURST ST",
            "address_2": "SUITE LL0300",
            "city": "FOUNTAIN VALLEY",
            "state": "CA",
            "postal_code": "927086728",
            "telephone_number": "714-962-7100",
            "fax_number": "714-963-7600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEMORIAL RADIATION ONCOLOGY MEDICAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-11-26",
        "last_updated": "2025-10-15",
        "certification_date": "2025-10-15",
        "status": "A",
        "authorized_official_last_name": "HARSOLIA",
        "authorized_official_first_name": "ASIF",
        "authorized_official_middle_name": "R.",
        "authorized_official_title_or_position": "MD/AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "562-492-6695",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fountain Valley, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.