COASTAL RADIATION ONCOLOGY MEDICAL GROUP, INC. (NPI# 1093749129) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1093749129 |
| Entity Type | Organization |
| Organization Name | COASTAL RADIATION ONCOLOGY MEDICAL GROUP, INC. |
| Other Organization Name | SANTA MARIA RADIATION ONCOLOGY MEDICAL CENTER, INC. |
| Practice Address |
1325 E Church St Ste 101 Santa Maria CA 93454-5915 |
| Practice Telephone | 8059252529 |
| Practice Fax Number | 8059284478 |
| Mailing Telephone | 8004371619 |
| Enumeration Date | 2006-07-11 |
| Last Update Date | 2020-01-02 |
| Authorized Official Name | DR. JEFFREY M RODNICK (PRESIDENT) |
| Authorized Official Telephone | 8056485191 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2085R0001X |
Radiology Specialization: Radiation Oncology |
Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Santa Maria Radiation Oncology Medical Center, Inc. | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932131158 | Coastal Radiation Oncology Medical Group, Inc. | Radiology | 2985 Sycamore Dr, Simi Valley, CA 93065-1201 | 2006-07-07 |
| 1730111931 | Coastal Radiation Oncology Medical Group, Inc. | Radiology | 100 Casa St, Suite C, San Luis Obispo, CA 93405-1883 | 2006-07-07 |
| 1699707885 | Coastal Radiation Oncology Medical Group, Inc. | Radiology | 1069 Los Palos Dr, Salinas, CA 93901-3916 | 2006-07-07 |
| 1972535359 | Coastal Radiation Oncology Medical Group, Inc. | Radiology | 274 Heather Ct, Templeton, CA 93465-9738 | 2006-07-07 |
| 1922038173 | Coastal Radiation Oncology Medical Group, Inc. | Radiology | 100 Casa St, Suite C, San Luis Obispo, CA 93405-1883 | 2006-07-04 |
| 1922038009 | Coastal Radiation Oncology Medical Group, Inc. | Radiology | 2900 Loma Vista Rd, 100, Ventura, CA 93003-2920 | 2006-07-04 |
| 1811927999 | Coastal Radiation Oncology Medical Group, Inc. | Radiology | 2230 Lynn Rd, Suite 103, Thousand Oaks, CA 91360-1901 | 2006-07-04 |
| 1083644165 | Coastal Radiation Oncology Medical Group, Inc. | Radiology | 1240 S Westlake Blvd, Suite 103, Westlake Village, CA 91361-1929 | 2006-07-04 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | COASTAL RADIATION ONCOLOGY MEDICAL GROUP, INC., | 1069 Los Palos Dr, Salinas, CA 93901-3916 |
| Street Address |
1325 E CHURCH ST STE 101 |
| City | SANTA MARIA |
| State | CA |
| Zip Code | 93454-5915 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033193297 | Case H Ketting | Specialist | 1325 E Church St Ste 101, Santa Maria, CA 93454 | 2005-12-01 |
| 1447516711 | Central Coast Medical Oncology Corp | Internal Medicine | 1325 E Church St Ste 101, Santa Maria, CA 93454-5915 | 2012-04-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164995825 | Virgilia Elizabeth Kennedy | Counselor | 1505 Shepard Drive, Suite 204, Santa Maria, CA 93454 | 2019-01-05 |
| 1891290151 | Philbert Ramirez Pandac | Behavioral Analyst | 1016 East Maint Street, Santa Maria, CA 93454 | 2018-03-28 |
| 1487166120 | Good Samaritan Shelter | Family Medicine | 412 East Tunnell Street, Santa Maria, CA 93454 | 2017-11-03 |
| 1306357892 | Aklilu Joseph | Pharmacist | 1700 S. Bradley Rd, Santa Maria, CA 93454 | 2017-10-24 |
| 1225557267 | Eric Edward Lofstrand | Counselor | 1214 S Miller St Ste 11, Santa Maria, CA 93454 | 2017-09-11 |
| 1881112449 | Tess Wianecki | Physician Assistant | 116 S Palisade Dr Ste 110, Santa Maria, CA 93454 | 2017-09-05 |
| 1730603705 | Cac Alvin Center | Counselor | 316 E Mcelhany Ave, Santa Maria, CA 93454 | 2017-08-01 |
| 1174045009 | Peter A. Statti Md Inc. | Pediatrics | 1414 S. Miller St. #12, Santa Maria, CA 93454 | 2017-07-12 |
| 1982143970 | Child Abuse Listening Mediation | Community/Behavioral Health | 210 E. Enos Dr., Ste. A, Santa Maria, CA 93454 | 2017-02-23 |
| 1821531344 | Maria Isabel Lara | Counselor | 210 E Enos Dr, Santa Maria, CA 93454 | 2016-12-01 |
| Find all providers in zip 93454 | ||||
| Taxonomy Code | 2085R0001X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Radiation Oncology |
| A radiologist who deals with the therapeutic applications of radiant energy and its modifiers and the study and management of disease, especially malignant tumors. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538149224 | Sheri D Marquez | Radiology | 314 S Stratford Ave, Santa Maria, CA 93454-5903 | 2006-01-19 |
| 1336331289 | Jeffrey Kai Wu | Radiology | 1325 E Church St, Suite 101, Santa Maria, CA 93454-5909 | 2007-08-14 |
| 1588668271 | Central Coast Medical Oncology Corp | Radiology | 1325 E Church St, Ste. 301, Santa Maria, CA 93454 | 2005-06-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154933034 | Andrew Lim | Radiology | 200 Medical Plaza Driveway Suite B265, Los Angeles, CA 90095-0001 | 2020-08-20 |
| 1083275200 | Centerpoint Radiation Oncology, Inc. | Radiology | 8929 Wilshire Blvd Ste 100, Beverly Hills, CA 90211-1950 | 2019-06-27 |
| 1922450840 | Cynthia Bajada Chasan | Radiology | 7401 Vista Del Mar Ave, La Jolla, CA 92037-4954 | 2016-07-02 |
| 1871906396 | Sammy Mohamed Ashouri | Radiology | 300 Pasteur Dr Rm H1330, Stanford, CA 94305 | 2014-06-03 |
| 1235540469 | Julian C Hong | Radiology | 1825 4th St Rm M2260, San Francisco, CA 94143-2350 | 2014-05-09 |
| 1295155422 | Rishabh Chaudhari | Radiology | 880 E Tuolumne Rd Ste 101, Turlock, CA 95382-1549 | 2014-04-28 |
| 1407278211 | Vincent S. T. Cheng | Radiology | 6022 W Sweet Dr, Visalia, CA 93291-8924 | 2014-01-13 |
| 1487085221 | Peter Allison Austin | Radiology | 1655 Aspen Grove Ln, Diamond Bar, CA 91765-2953 | 2013-12-04 |
| 1760820666 | Sandra Birdwell | Radiology | 1865 Camino De Los Robles, Menlo Park, CA 94025-5912 | 2013-06-13 |
| 1063859874 | John Vidyadhar Hegde | Radiology | Ucla Medical Center Department of Radiation, 200 Ucla Medical Center, Suite B265, Los Angeles, CA 90095-0001 | 2013-06-03 |
| Find all providers with the same taxonomy | ||||
| City | SANTA MARIA |
| Zip Code | 93454 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.