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General NPI Number Information
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NPI Number | 1306988381
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Entity Type | Organization
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Legal Business Name | SANTA CRUZ RADIATION ONCOLOGY MEDICAL GROUP, INCORPORATED
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Dates
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Enumeration Date | 02/13/2007
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Last Update Date | 06/23/2015
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Provider Practice Location Address
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Address Line | 1575 SOQUEL DR SUITE 100
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City | SANTA CRUZ
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State | CA
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Zip | 95065-1700
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Country | US
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Telephone | 831-462-3050
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Fax | 831-462-6068
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Provider Business Mailing Address
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Address Line | 1575 SOQUEL DR SUITE 100
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City | SANTA CRUZ
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State | CA
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Zip | 95065-1700
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Country | US
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Telephone | 831-462-3050
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Fax | 831-462-6068
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JAY A. MEISEL
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Credential | M.D.
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Telephone | 831-462-3050
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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 |
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