Organization
EDWARD C GREENLEAF
Active
Other names
RADIATION ONCOLOGY MEDICAL ASSOCIATES
Organization subpart
No
Provider details
NPI number
Authorized official
DR. EDWARD C GREENLEAF M.D. (MEDICAL DIRECTOR)
(209) 481-8312
Entity
Organization
Contact information
Practice address
2027 GRAND CANAL BLVD STE 25, STOCKTON, CA 95207-6650
(209) 475-1111
(209) 475-1119
Mailing address
PO BOX 14, STOCKTON, CA 95201-0014
(209) 475-1111
(209) 475-1119
Taxonomy
Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
Primary
G51488
CA
2085R0203X
Therapeutic Radiology Physician
G51488
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR0044200
—
CA
Enumeration date
04/23/2007
Last updated
06/18/2008
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