Organization
MARIN RADIATION ONCOLOGY MEDICAL GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ERNEST WAYNE TORIGOE MD (DIRECTOR MEDICAL)
(209) 342-2300
Entity
Organization
Contact information
Practice address
1350 S ELISEO DR, 100, GREENBRAE, CA 94904-2011
(209) 342-2300
(209) 524-4240
Mailing address
4301 NORTHSTAR WAY, MODESTO, CA 95356-9262
(209) 342-2300
(209) 524-4240
Taxonomy
Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
Primary
—
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR0046360
—
CA
01
—
ZZZ25782Z
BLUE SHIELD
CA
Enumeration date
11/16/2005
Last updated
12/08/2008
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