Provider Demographics
NPI:1184789232
Name:RADIATION ONCOLOGY OF SAN ANTONIO, PA
Entity type:Organization
Organization Name:RADIATION ONCOLOGY OF SAN ANTONIO, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:RAJIV
Authorized Official - Middle Name:S
Authorized Official - Last Name:DAHIYA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:210-299-8000
Mailing Address - Street 1:PO BOX 10050
Mailing Address - Street 2:
Mailing Address - City:MANHATTAN BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90267-7550
Mailing Address - Country:US
Mailing Address - Phone:310-335-4056
Mailing Address - Fax:310-335-4098
Practice Address - Street 1:215 E QUINCY ST
Practice Address - Street 2:STE B100
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78215-2039
Practice Address - Country:US
Practice Address - Phone:210-299-8000
Practice Address - Fax:210-299-8099
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-27
Last Update Date:2010-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXCP7217OtherRR MEDICARE
TX156761201Medicaid
TX00327UMedicare PIN