Memorial Radiation Oncology Medical Group

Primary specialty

Radiation Oncology PhysicianTaxonomy code 2085R0001X

Legal business name

MEMORIAL RADIATION ONCOLOGY MEDICAL GROUP

Practice address

24953 Paseo de Valencia
Laguna Hills, CA 92653-4342

Phone

(562) 492-6695

Fax

(562) 988-0389

NPI assigned

Dec 10, 2013

Organization subpart

No

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

Authorized official

Name

Ajmel Puthawala, M.D.

Title

Partner

Phone

(562) 492-6695

Specialties & licenses 1

Addresses

Other names 1

• saddleback radiation oncology medical group Former legal business name

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.

• Memorial Radiation Oncology Medical

  • Radiation Oncology Physician
  • Fountain Valley, CA
  • NPI 1639509706
  NPD tax ID

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

{
    "created_epoch": "1386633600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1386633600000",
    "number": "1801227285",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2650 ELM AVE",
            "address_2": "201",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908061651",
            "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": "24953 PASEO DE VALENCIA",
            "city": "LAGUNA HILLS",
            "state": "CA",
            "postal_code": "926534342",
            "telephone_number": "562-492-6695",
            "fax_number": "562-988-0389"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEMORIAL RADIATION ONCOLOGY MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-12-10",
        "last_updated": "2013-12-10",
        "status": "A",
        "authorized_official_last_name": "PUTHAWALA",
        "authorized_official_first_name": "AJMEL",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "562-492-6695",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2085R0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Radiology, Radiation Oncology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "saddleback radiation oncology medical group",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• John Thomas Meinhardt
• Jerome Dizon Melad
• Ryland E Melford III, MD
• Ghada Melik
• Memorial Radiation Oncology Medical
• Memorialcare Health System
• Memorialcare Home Health - LLC
• Memorialcare Surgical Center at Saddleback LLC
• Lisamarie Menard, AMFT
• Susan A Mendelsohn, MD

• All providers in Laguna Hills, CA
• Radiation Oncology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2013; 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.