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Organization
ST. MARYS RADIATION ONCOLOGY MEDICAL GROUP
Active
Organization
ST. MARYS RADIATION ONCOLOGY MEDICAL GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DEBBY CURRY (ACCOUNT MANAGER)
(951) 691-5123
Entity
Organization
Contact information
Practice address
1043 ELM AVE, SUITE 110, LONG BEACH, CA 90813-3271
(909) 263-0321
(951) 691-5156
Mailing address
PO BOX 575, MURRIETA, CA 92564-0575
(951) 691-5123
(951) 691-5156
Taxonomy
Speciality
Code
Description
License number
State
261QX0203X
Radiation Oncology Clinic/Center
Primary
A23750
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR0077720
—
CA
01
—
ZZZ5444Z
BLUE SHIELD
CA
Enumeration date
07/23/2006
Last updated
03/26/2015
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