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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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