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Organization
VALLEY RADIOTHERAPY ASSOCIATES MEDICAL GROUP INC
Active
Organization
VALLEY RADIOTHERAPY ASSOCIATES MEDICAL GROUP INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LESLIE E BOTNICK MD (CMO)
(310) 335-4065
Entity
Organization
Contact information
Practice address
1500 ROSECRANS AVE, 400, MANHATTAN BEACH, CA 90266-3763
(310) 335-4056
Mailing address
PO BOX 10050, MANHATTAN BEACH, CA 90267-7550
(310) 416-8956
(310) 536-9123
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CH4367
RR MEDICARE ST. JUDE
CA
01
—
CJ5668
RR MEDICARE RIVERSIDE
CA
01
—
CP3272
RRMEDICARE SJHC
CA
01
—
CR0476
RR MEDICARE PSJ
CA
01
—
DD9966
RR MEDICARE EL CENTRO
CA
05
—
GR0013790
—
CA
05
—
GR0013791
—
CA
05
—
GR0013792
—
CA
05
—
GR0013793
—
CA
05
—
GR0013794
—
CA
05
—
GR0013796
—
CA
05
—
GR0013797
—
CA
05
—
GR0013798
—
CA
05
—
GR0013799
—
CA
05
—
GR001379A
—
CA
05
—
GR001379B
—
CA
05
—
GR001379C
—
CA
05
—
GR001379D
—
CA
05
—
GR001379E
—
CA
05
—
GR001379F
—
CA
Enumeration date
05/17/2006
Last updated
03/06/2014
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