Organization
EAST BAY RADIATION ONCOLOGY MEDICAL GROUP, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CARL CRAIG VAN WEY M.D. (SECRETARY)
(510) 581-0556
Entity
Organization
Contact information
Practice address
20126 STANTON AVE STE 101, CASTRO VALLEY, CA 94546-5270
(510) 581-0556
(510) 581-2161
Mailing address
20126 STANTON AVE STE 101, CASTRO VALLEY, CA 94546-5270
(510) 581-0556
(510) 581-2161
Taxonomy
Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4541522
—
CA
Enumeration date
06/29/2006
Last updated
08/22/2020
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