Provider Demographics
NPI:1922044874
Name:WOODHOUSE & KARON, A MEDICAL CORPORATION
Entity Type:Organization
Organization Name:WOODHOUSE & KARON, A MEDICAL CORPORATION
Other - Org Name:RADIATION ONCOLOGY MEDICAL GROUP OF SOUTHERN CA, INC.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:J
Authorized Official - Last Name:WOODHOUSE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:714-991-3380
Mailing Address - Street 1:1211 W LA PALMA AVE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:ANAHEIM
Mailing Address - State:CA
Mailing Address - Zip Code:92801-2815
Mailing Address - Country:US
Mailing Address - Phone:714-991-3380
Mailing Address - Fax:714-991-5206
Practice Address - Street 1:1211 W LA PALMA AVE
Practice Address - Street 2:SUITE 100
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92801-2815
Practice Address - Country:US
Practice Address - Phone:714-991-3380
Practice Address - Fax:714-991-5206
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-21
Last Update Date:2010-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA2085R0001X2085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation OncologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ77835ZMedicaid
CAW19364Medicare ID - Type Unspecified