Organization
NORTHERN CALIFORNIA RADIATION THERAPISTS & ONCOLOGISTS MEDICAL GROUP I
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN W LEE MD (MEDICAL DIRECTOR)
(209) 342-2300
Entity
Organization
Contact information
Practice address
2333 BUCHANAN ST, SAN FRANCISCO, CA 94115-1925
(209) 342-2300
(209) 524-4240
Mailing address
450 GLASS LN STE C, MODESTO, CA 95356-9287
(209) 342-2300
(209) 524-4240
Taxonomy
Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
Primary
102829
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR0054561
—
CA
01
—
ZZZ27539Z
BLUE SHIELD
CA
01
—
ZZZ75605Z
BLUE SHIELD
CA
05
—
ZZZ75605Z
—
CA
01
—
ZZZ77840Z
BLUE SHIELD
CA
05
—
ZZZ77840Z
—
CA
01
—
ZZZ86312Z
BLUE SHIELD
CA
05
—
ZZZ86312Z
—
CA
Enumeration date
11/07/2005
Last updated
09/13/2024
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