Individual provider Active NPI

Yuji Seo, M.D.

  • Radiation Oncology Physician
  • El Centro, CA
National Provider Identifier
1740493774
Registry record updated Nov 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiation Oncology PhysicianTaxonomy code 2085R0001X
License
C188890 Issued in CA
Practice address
1410 S la Brucherie Rd Ste B
El Centro, CA 92243-9676
Phone
(760) 339-5620
Fax
(760) 339-5621
NPI assigned
May 7, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 14, 2023

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 57.004909 OH
Radiation Oncology Physician 2085R0001X C188890 CA Primary

Addresses

Primary practice location

1410 S la Brucherie Rd Ste B
El Centro, CA 92243-9676

Mailing address

104 Woodmont Blvd Ste 500
Nashville, TN 37205-2245

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
I20240105002557 CA Practitioner - Radiation Oncology 6507217320 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Radiation Oncology
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Radiation Oncology Network of Southern CaliforniaGroup PAC ID 3870906092, 5 clinicians

Practice addresses (Care Compare)

1410 S la Brucherie Rd
Suite B
El Centro, CA 92243-9676
Phone (760) 339-5620

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
C188890CAMDRadiation Oncology Physician
57.004909OHMDRadiation Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Radiation Oncology Network of Southern California CurrentSince Feb 1, 2024 Accepting new patients

Locations

959 Lane Ave
Chula Vista, CA 91914
Phone (619) 502-7730

1410 S La Brucherie Rd
#B
El Centro, CA 92243
Phone (760) 339-5620

104 Woodmont Blvd
Ste 500
Nashville, TN 37205
Phone (615) 467-7400

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 1

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

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1178496000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699920000000",
    "number": "1740493774",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "104 WOODMONT BLVD STE 500",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372052245"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1410 S LA BRUCHERIE RD STE B",
            "city": "EL CENTRO",
            "state": "CA",
            "postal_code": "922439676",
            "telephone_number": "760-339-5620",
            "fax_number": "760-339-5621"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SEO",
        "first_name": "YUJI",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-07",
        "last_updated": "2023-11-14",
        "certification_date": "2023-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "OH",
            "license": "57.004909",
            "primary": false
        },
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "CA",
            "license": "C188890",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in El Centro, CA

Sources for this page

Verify at the official NPI Registry.