RIVERSIDE RADIATION ONCOLOGY MEDICAL GROUP (NPI# 1417218124) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417218124 |
| Entity Type | Organization |
| Organization Name | RIVERSIDE RADIATION ONCOLOGY MEDICAL GROUP |
| Practice Address |
4500 Brockton Ave 101 Riverside CA 92501-4090 |
| Mailing Address |
2650 Elm Ave 201 Long Beach CA 90806-1651 |
| Practice Telephone | 9517883000 |
| Mailing Telephone | 5624926695 |
| Mailing Fax Number | 5629880389 |
| Enumeration Date | 2012-05-30 |
| Last Update Date | 2012-05-30 |
| Authorized Official Name | DR. ALAM SYED (DIRECTOR) |
| Authorized Official Telephone | 5624926695 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2085R0001X |
Radiology Specialization: Radiation Oncology |
Allopathic & Osteopathic Physicians |
| Street Address |
4500 BROCKTON AVE 101 |
| City | RIVERSIDE |
| State | CA |
| Zip Code | 92501-4090 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699770974 | Jan Paul Maddox | Pain Medicine | 4500 Brockton Ave, Ste 305, Riverside, CA 92501-4028 | 2005-06-14 |
| 1831656578 | Lucyana Magrietta Panjaitan | Nurse Practitioner | 4500 Brockton Ave, Riverside, CA 92501-4090 | 2019-02-28 |
| 1518401546 | Faculty Physicians and Surgeons of Llusm | Physician Assistant | 4500 Brockton Ave, Ste 201, Riverside, CA 92501-4090 | 2016-12-09 |
| 1396108940 | Thaker Urological Center, Inc. | Specialist | 4500 Brockton Ave, Suite 204, Riverside, CA 92501-4090 | 2016-03-31 |
| 1063874337 | Mission Urology, Inc. | Internal Medicine | 4500 Brockton Ave, Suite 301, Riverside, CA 92501-4027 | 2016-03-24 |
| 1558759969 | Mid-valley Surgicenter Inc | Clinic/Center | 4500 Brockton Ave, Suite 105, Riverside, CA 92501-4090 | 2015-01-07 |
| 1306254669 | Jocelyn Cases | Nurse Practitioner | 4500 Brockton Ave, Suite 315, Riverside, CA 92501-4090 | 2014-07-30 |
| 1841530169 | Jennifer Lynn Gilden | Physician Assistant | 4500 Brockton Ave, Riverside, CA 92501-4090 | 2013-02-22 |
| 1275881609 | Sri Gorty M.d. Inc | Radiology | 4500 Brockton Ave, 101, Riverside, CA 92501-4090 | 2012-08-15 |
| 1780931709 | Munther Alqaisi M.d. A Professional Medical Corporation | Radiology | 4500 Brockton Ave, 101, Riverside, CA 92501-4090 | 2012-08-08 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700437605 | Mary Horvatin | Technician | 1811 Rivera Strret, Riverside, CA 92501 | 2019-09-23 |
| 1366905473 | Timothy Daniel Collins | Student in an Organized Health Care Education/Training Program | Riverside Community Hospital, 4445 Magnolia Ave., Gme, Office, Riverside, CA 92501 | 2019-04-08 |
| 1346709672 | Lourdes Adame | Student in an Organized Health Care Education/Training Program | 4445 Magnolia Ave - Gme Office, Riverside, CA 92501 | 2019-03-16 |
| 1740759067 | Kristina Ferris-celosse | Counselor | 2452 Wilshire St., Riverside, CA 92501 | 2018-11-15 |
| 1750888095 | Arunmozhi Aravagiri | Student in an Organized Health Care Education/Training Program | Riverside Community Hospital, Gme Office, 4445 Magnolia Ave., Riverside, CA 92501 | 2018-04-12 |
| 1720585847 | Alan Huynh | Student in an Organized Health Care Education/Training Program | 4445 Magnolia Avenue., Gme Office, Riverside, CA 92501 | 2018-04-06 |
| 1538664834 | Wilson Paul Frasca | Student in an Organized Health Care Education/Training Program | 4445 Magnolia Avenue, Riverside, CA 92501 | 2018-03-28 |
| 1851896575 | Geethu Gopinathan Nair | Student in an Organized Health Care Education/Training Program | Riverside Community Hospital, 4445 Magnolia Ave., Gme Office, Riverside, CA 92501 | 2018-03-26 |
| 1316465560 | Thilini Anne Abeygunaratne | Marriage & Family Therapist | 1950 Market Street, Riverside, CA 92501 | 2017-09-07 |
| 1194257410 | Melissa Chitwood | Assistant Behavior Analyst | 3078 Cedar St., Riverside, CA 92501 | 2017-03-28 |
| Find all providers in zip 92501 | ||||
| Taxonomy Code | 2085R0001X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Radiation Oncology |
| A radiologist who deals with the therapeutic applications of radiant energy and its modifiers and the study and management of disease, especially malignant tumors. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245388289 | Afshin Rashtian | Radiology | 4500 Brockton Ave Ste 101, Riverside, CA 92501-4027 | 2007-01-08 |
| 1952309056 | Susanna Reba Gordon | Radiology | 6939 Palm Ct, Riverside, CA 92506-2815 | 2005-07-12 |
| 1962993840 | Synergy Radiation Oncology Medical Group, Inc. | Radiology | 4500 Brockton Ave Ste 101, Riverside, CA 92501-4027 | 2018-05-25 |
| 1275881609 | Sri Gorty M.d. Inc | Radiology | 4500 Brockton Ave, 101, Riverside, CA 92501-4090 | 2012-08-15 |
| 1780931709 | Munther Alqaisi M.d. A Professional Medical Corporation | Radiology | 4500 Brockton Ave, 101, Riverside, CA 92501-4090 | 2012-08-08 |
| 1508113523 | A.m. Nisar Syed A Professional Medical Corporation | Radiology | 4500 Brockton Ave, 101, Riverside, CA 92501-4090 | 2012-08-08 |
| 1528134947 | Riverside Healthcare System Lp | Radiology | 4500 Brockton Ave, Suite 101, Riverside, CA 92501-4090 | 2006-11-28 |
| 1558395558 | Janet Hocko | Radiology | 6939 Palm Ct, Riverside, CA 92506-2815 | 2006-07-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154933034 | Andrew Lim | Radiology | 200 Medical Plaza Driveway Suite B265, Los Angeles, CA 90095-0001 | 2020-08-20 |
| 1083275200 | Centerpoint Radiation Oncology, Inc. | Radiology | 8929 Wilshire Blvd Ste 100, Beverly Hills, CA 90211-1950 | 2019-06-27 |
| 1922450840 | Cynthia Bajada Chasan | Radiology | 7401 Vista Del Mar Ave, La Jolla, CA 92037-4954 | 2016-07-02 |
| 1871906396 | Sammy Mohamed Ashouri | Radiology | 300 Pasteur Dr Rm H1330, Stanford, CA 94305 | 2014-06-03 |
| 1235540469 | Julian C Hong | Radiology | 1825 4th St Rm M2260, San Francisco, CA 94143-2350 | 2014-05-09 |
| 1295155422 | Rishabh Chaudhari | Radiology | 880 E Tuolumne Rd Ste 101, Turlock, CA 95382-1549 | 2014-04-28 |
| 1407278211 | Vincent S. T. Cheng | Radiology | 6022 W Sweet Dr, Visalia, CA 93291-8924 | 2014-01-13 |
| 1487085221 | Peter Allison Austin | Radiology | 1655 Aspen Grove Ln, Diamond Bar, CA 91765-2953 | 2013-12-04 |
| 1760820666 | Sandra Birdwell | Radiology | 1865 Camino De Los Robles, Menlo Park, CA 94025-5912 | 2013-06-13 |
| 1063859874 | John Vidyadhar Hegde | Radiology | Ucla Medical Center Department of Radiation, 200 Ucla Medical Center, Suite B265, Los Angeles, CA 90095-0001 | 2013-06-03 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.