Active NPI
Jonathan R Stella, MD
- Radiation Oncology Physician
- San Luis Obispo, CA
National Provider Identifier
1790787141
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Radiation Oncology Physician
- License
- A43943
- Practice address
- 100 Casa St
Suite C
San Luis Obispo, CA 93405-1883 - Phone
- (805) 541-1932
- Fax
- (805) 541-1653
- NPI assigned
- Aug 15, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Radiation Oncology Physician | 2085R0001X | A43943 | CA | Primary |
Addresses
Primary practice location
100 Casa St
Suite C
San Luis Obispo, CA 93405-1883
Mailing address
PO Box 849697
Los Angeles, CA 90084-9697
Phone (805) 648-5191
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A43943 | CA | MD | Radiation Oncology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1124064000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1666310400000",
"number": "1790787141",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 849697",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900849697",
"telephone_number": "805-648-5191",
"fax_number": "805-648-3458"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "100 CASA ST",
"address_2": "SUITE C",
"city": "SAN LUIS OBISPO",
"state": "CA",
"postal_code": "934051883",
"telephone_number": "805-541-1932",
"fax_number": "805-541-1653"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STELLA",
"first_name": "JONATHAN",
"middle_name": "R",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-08-15",
"last_updated": "2022-10-21",
"certification_date": "2022-10-21",
"status": "A"
},
"taxonomies": [
{
"code": "2085R0001X",
"taxonomy_group": "",
"desc": "Radiology, Radiation Oncology",
"state": "CA",
"license": "A43943",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in San Luis Obispo, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.