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General NPI Number Information
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NPI Number | 1184924193
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Entity Type | Organization
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Legal Business Name | GOLDEN STATE RADIATION ONCOLOGY, INC
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Dates
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Enumeration Date | 10/25/2010
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Last Update Date | 03/16/2023
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Provider Practice Location Address
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Address Line | 21300 ERWIN ST
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City | WOODLAND HILLS
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State | CA
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Zip | 90211-1950
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Country | US
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Telephone | 424-249-7500
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Fax | 818-610-7461
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Provider Business Mailing Address
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Address Line | 104 WOODMONT BLVD STE 500
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City | NASHVILLE
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State | TN
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Zip | 37205-2245
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Country | US
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Telephone | 713-589-6879
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Fax | 713-795-5081
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Authorized Official
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Title or Position | OWNER
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Name | RANDALL A SCHARLACH
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Credential | MD
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Telephone | 818-449-2700
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0001X
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Taxonomy Name | Radiation Oncology Physician
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License Number | A71358
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License Number State | CA
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