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General NPI Number Information
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NPI Number | 1831120633
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Entity Type | Organization
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Legal Business Name | THE RADIATION MEDICAL GROUP INC
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Dates
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Enumeration Date | 07/06/2006
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Last Update Date | 12/20/2011
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Provider Practice Location Address
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Address Line | 5395 RUFFIN RD STE 103
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City | SAN DIEGO
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State | CA
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Zip | 92123-1338
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Country | US
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Telephone | 858-505-4100
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Fax | 858-751-0601
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Provider Business Mailing Address
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Address Line | PO BOX 33865
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City | SAN DIEGO
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State | CA
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Zip | 92163-3865
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Country | US
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Telephone | 858-888-7700
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Fax | 858-888-7721
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Authorized Official
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Title or Position | CFO/EXECUTIVE DIRECTOR
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Name | DOUGLAS MYKING
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Credential |
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Telephone | 619-220-4100
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State |
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