Organization
V. VONGTAMA, M.D., INC.
Active
Other names
East Bay Regional Cancer Center
Organization subpart
No
Provider details
NPI number
Authorized official
DR. VITUNE VONTAMA MD (OWNER)
(949) 721-6533
Entity
Organization
Contact information
Practice address
1034 A ST, HAYWARD, CA 94541-4106
(209) 342-5516
Mailing address
4722 QUAIL LAKES DR, STOCKTON, CA 95207-5244
(209) 342-5516
Taxonomy
Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
Primary
A29753
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A297530
—
CA
Enumeration date
02/06/2008
Last updated
04/17/2012
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