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General NPI Number Information
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NPI Number | 1225010234
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Entity Type | Organization
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Legal Business Name | CENTRIC RADIATION ONCOLOGY PC
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Dates
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Enumeration Date | 11/16/2005
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 470 JOHN YOUNG WAY SUITE 400
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City | EXTON
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State | PA
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Zip | 19341
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Country | US
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Telephone | 610-524-5550
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Fax | 610-524-5546
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Provider Business Mailing Address
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Address Line | PO BOX 30560
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City | LOS ANGELES
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State | CA
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Zip | 90030-0560
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Country | US
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Telephone | 310-335-4000
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Fax | 310-335-4098
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | DR. RICHARD M YELOVICH
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Credential | MD
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Telephone | 610-524-5550
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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 |
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License Number State | PA
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