COASTAL RADIATION ONCOLOGY MEDICAL GROUP, INC. (NPI# 1730111931) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1730111931 |
| Entity Type | Organization |
| Organization Name | COASTAL RADIATION ONCOLOGY MEDICAL GROUP, INC. |
| Other Organization Name | SAN LUIS RADIATION ONCOLOGY MEDICAL CENTER, INC. |
| Practice Address |
100 Casa St Suite C San Luis Obispo CA 93405-1883 |
| Mailing Address |
Dept 9697 Los Angeles CA 90084-9697 |
| Practice Telephone | 8055411932 |
| Practice Fax Number | 8055411653 |
| Mailing Telephone | 9497216520 |
| Mailing Fax Number | 9497216120 |
| Enumeration Date | 2006-07-07 |
| Last Update Date | 2008-01-29 |
| Authorized Official Name | DR. JONATHAN R STELLA (PRESIDENT) |
| Authorized Official Telephone | 8055411932 |
| 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 |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | GR0005751 | 05 |
| Other Name | Type Code |
|---|---|
| San Luis Radiation Oncology Medical Center, Inc. | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093749129 | Coastal Radiation Oncology Medical Group, Inc. | Radiology | 1325 E Church St Ste 101, Santa Maria, CA 93454-5915 | 2006-07-11 |
| 1932131158 | Coastal Radiation Oncology Medical Group, Inc. | Radiology | 2985 Sycamore Dr, Simi Valley, CA 93065-1201 | 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 |
100 CASA ST SUITE C |
| City | SAN LUIS OBISPO |
| State | CA |
| Zip Code | 93405-1883 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790787141 | Jonathan R Stella | Radiology | 100 Casa St, Suite C, San Luis Obispo, CA 93405-1883 | 2005-08-15 |
| 1356755789 | Pacific Central Coast Health Centers | Clinic/Center | 100 Casa St, Suite B, San Luis Obispo, CA 93405-1883 | 2014-06-13 |
| 1972821601 | Lauren Marie Tait | Radiology | 100 Casa St, Suite C, San Luis Obispo, CA 93405-1883 | 2010-05-05 |
| 1376556217 | Central Coast Obstetrics and Gynecology, Inc., A Medical Group | Obstetrics & Gynecology | 100 Casa St, Suite B, San Luis Obispo, CA 93405-1883 | 2006-08-14 |
| 1235150921 | Melody Kopisch | Nurse Practitioner | 100 Casa St, Suite B, San Luis Obispo, CA 93405-1883 | 2006-07-21 |
| 1720004237 | Barbara Lynne Clutter | Obstetrics & Gynecology | 100 Casa St, Suite B, San Luis Obispo, CA 93405-1883 | 2006-07-15 |
| 1922038173 | Coastal Radiation Oncology Medical Group, Inc. | Radiology | 100 Casa St, Suite C, San Luis Obispo, CA 93405-1883 | 2006-07-04 |
| 1821078692 | Leonard A. Cedars | Obstetrics & Gynecology | 100 Casa St, Suite D-3, San Luis Obispo, CA 93405-1883 | 2006-01-18 |
| 1649250424 | Nihal Naccasha | Obstetrics & Gynecology | 100 Casa St, Suite D-3, San Luis Obispo, CA 93405-1883 | 2006-01-18 |
| 1639159411 | Central Coast Maternal-fetal Medicine | Obstetrics & Gynecology | 100 Casa St, Suite D-3, San Luis Obispo, CA 93405-1883 | 2006-01-18 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164076626 | Hilary Abbott Anderson | Physician Assistant | 127 Casa St., San Luis Obispo, CA 93405 | 2019-08-01 |
| 1811465834 | Fatemeh Ladan Ahmadinia | Dentist | 764 N Santa Rosa St, San Luis Obispo, CA 93405 | 2018-11-07 |
| 1538559794 | Arnold Martin Horwitz | Marriage & Family Therapist | 1605 Garnette Drive, San Luis Obispo, CA 93405 | 2015-01-27 |
| 1750794764 | Solmaz Naghsh | Pharmacist | 765 Foothill Blvd, San Luis Obispo, CA 93405 | 2014-06-06 |
| 1609293471 | Robert S. Flores Dmd, Inc | Dentist | 878 Boysen Avenue, San Luis Obispo, CA 93405 | 2014-03-18 |
| 1457776445 | Laura Anne Wilvert | Marriage & Family Therapist | 793 E. Foothill Blvd, Suite A, #278, San Luis Obispo, CA 93405 | 2014-02-27 |
| 1497181200 | Tracey Ruby Madrigal | Counselor | 1106 Oceanaire Dr. #25, San Luis Obispo, CA 93405 | 2013-09-25 |
| 1437597572 | Sarah Michelle Brenis | Counselor | 524 Princeton Place, San Luis Obispo, CA 93405 | 2013-06-11 |
| 1013350974 | Jenna Rose Ramos | Counselor | 1459 Descanso St., San Luis Obispo, CA 93405 | 2013-04-10 |
| 1700140696 | Christopher Dieterich Marchand | Social Worker | 793a E. Foothill Blvd, 190, San Luis Obispo, CA 93405 | 2012-06-26 |
| Find all providers in zip 93405 | ||||
| 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 |
|---|---|---|---|---|
| 1790787141 | Jonathan R Stella | Radiology | 100 Casa St, Suite C, San Luis Obispo, CA 93405-1883 | 2005-08-15 |
| 1972821601 | Lauren Marie Tait | Radiology | 100 Casa St, Suite C, San Luis Obispo, CA 93405-1883 | 2010-05-05 |
| 1922038173 | Coastal Radiation Oncology Medical Group, Inc. | Radiology | 100 Casa St, Suite C, San Luis Obispo, CA 93405-1883 | 2006-07-04 |
| 1508858465 | Robert Irl Fishburn | Radiology | 100 Casa St, Suite C, San Luis Obispo, CA 93405-1883 | 2005-08-17 |
| 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 | SAN LUIS OBISPO |
| Zip Code | 93405 |
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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.