Provider Demographics
NPI:1457486433
Name:NORTH COUNTY ONCOLOGY MEDICAL CLINIC INC
Entity Type:Organization
Organization Name:NORTH COUNTY ONCOLOGY MEDICAL CLINIC INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:WARREN
Authorized Official - Middle Name:STEVEN
Authorized Official - Last Name:PAROLY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:760-758-5770
Mailing Address - Street 1:3617 VISTA WAY
Mailing Address - Street 2:
Mailing Address - City:OCEANSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92056-4522
Mailing Address - Country:US
Mailing Address - Phone:760-758-5770
Mailing Address - Fax:760-721-8597
Practice Address - Street 1:3617 VISTA WAY
Practice Address - Street 2:
Practice Address - City:OCEANSIDE
Practice Address - State:CA
Practice Address - Zip Code:92056-4522
Practice Address - Country:US
Practice Address - Phone:760-758-5770
Practice Address - Fax:760-721-8597
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-22
Last Update Date:2011-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & OncologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA0R0010500Medicaid
CAW2855Medicare ID - Type Unspecified