Organization
X-RAY MEDICAL GROUP RADIATION ONCOLOGY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KELLY DEWITT MD (AUTHORIZED OFFICIAL)
(619) 740-4500
Entity
Organization
Contact information
Practice address
5555 GROSSMONT CENTER DR, LA MESA, CA 91942-3019
(619) 740-4500
(619) 740-8499
Mailing address
PO BOX 509015, DEPT 338, SAN DIEGO, CA 92150-9015
Taxonomy
Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CJ8070
RR MEDICARE
CA
05
—
GR0087890
—
CA
05
—
GR0087891
—
CA
05
—
GR0087892
—
CA
05
—
GR0087893
—
CA
Enumeration date
06/06/2006
Last updated
02/17/2026
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