Provider Demographics
NPI:1710914288
Name:USCC AQUISITIONS CORP
Entity Type:Organization
Organization Name:USCC AQUISITIONS CORP
Other - Org Name:SONORA REGIONAL RADIATION ONCOLOGY CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:GARY
Authorized Official - Middle Name:S
Authorized Official - Last Name:YOUNG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:949-721-6533
Mailing Address - Street 1:610 NEWPORT CENTER DR
Mailing Address - Street 2:SUITE 350
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92660-6419
Mailing Address - Country:US
Mailing Address - Phone:949-721-6540
Mailing Address - Fax:
Practice Address - Street 1:1 S FOREST RD
Practice Address - Street 2:
Practice Address - City:SONORA
Practice Address - State:CA
Practice Address - Zip Code:95370-4816
Practice Address - Country:US
Practice Address - Phone:209-536-0223
Practice Address - Fax:209-536-0226
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG615792085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation OncologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ZZZ39520ZMedicare ID - Type Unspecified