Provider Demographics
NPI:1881685527
Name:WESTERN RADIATION ONCOLOGY INC
Entity type:Organization
Organization Name:WESTERN RADIATION ONCOLOGY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ANKIT
Authorized Official - Middle Name:
Authorized Official - Last Name:AGARWAL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:650-940-7280
Mailing Address - Street 1:125 SOUTH DR
Mailing Address - Street 2:
Mailing Address - City:MOUNTAIN VIEW
Mailing Address - State:CA
Mailing Address - Zip Code:94040-4310
Mailing Address - Country:US
Mailing Address - Phone:650-940-7280
Mailing Address - Fax:650-988-7917
Practice Address - Street 1:125 SOUTH DR
Practice Address - Street 2:
Practice Address - City:MOUNTAIN VIEW
Practice Address - State:CA
Practice Address - Zip Code:94040-4310
Practice Address - Country:US
Practice Address - Phone:650-940-7280
Practice Address - Fax:650-988-7917
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-02
Last Update Date:2024-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation OncologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAGR0080592Medicaid
CAZZZ52889YOtherBLUE SHIELD
CAGR0080590Medicaid
CAGR0080593Medicaid
CAZZZ02838ZOtherBLUE SHIELD
CAZZZ02839ZOtherBLUE SHIELD
CAZZZ49854ZOtherBLUE SHIELD
CAZZZ02839ZOtherBLUE SHIELD
CAGR0080590Medicaid
CAZZZ52889YOtherBLUE SHIELD
CAGR0080592Medicaid
CAZZZ07586ZMedicare PIN