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NPI Code Detail

MEDICARE: DR. TAPAN ROY M.D.

MEDICARE: DR. TAPAN ROY M.D.
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
12085R0001XRadiation Oncology PhysicianR4B37MO
22085R0001XRadiation Oncology PhysicianC51244CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1165953OTHERMOBLUE CROSS PROVIDER ID
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3483437OTHERMOHEALTHLINK PROVIDER ID

General Provider Information

NPI Number : 1205831922
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. TAPAN ROY M.D.
Provider Business Mailing Address
First Line : 7330 HICKORYWOOD LN
Second Line :
City : PLEASANTON
State : CA
Zip : 94566-3584
Country : US
Telephone Number : 314-504-2009
Fax Number :
Provider Business Practice Location Address
First Line : 14662 NEWPORT AVE
Second Line :
City : TUSTIN
State : CA
Zip : 92780-6064
Country : US
Telephone Number : 714-573-9500
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/17/2005
Last Update Date : 01/17/2022

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Directions to “ DR. TAPAN ROY M.D.” Practice Location

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