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NPI Code Detail

MEDICARE: CLEVELAND RADIATION ONCOLOGY, INC

MEDICARE: CLEVELAND RADIATION ONCOLOGY, INC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1174400000XSpecialist

General Provider Information

NPI Number : 1457546475
Entity Type Code : Organization
Provider Name (Legal Business Name) : CLEVELAND RADIATION ONCOLOGY, INC
Provider Business Mailing Address
First Line : 2865 E COAST HWY
Second Line : 210
City : CORONA DEL MAR
State : CA
Zip : 92625-2236
Country : US
Telephone Number : 949-207-3111
Fax Number :
Provider Business Practice Location Address
First Line : 5260 SMITH RD
Second Line :
City : BROOKPARK
State : OH
Zip : 44142-1747
Country : US
Telephone Number : 216-265-4580
Fax Number :
Authorized Official
Title or Position : DIRECT OWNER
Name : DR. JON PRESCOTT
Credential :
Telephone Number : 440-816-6015
Provider Enumeration Date : 09/12/2007
Last Update Date : 10/14/2014

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Directions to “CLEVELAND RADIATION ONCOLOGY, INC ” Practice Location

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