Provider Demographics
NPI:1952547440
Name:RADU, CINDERELLA CHAVEZ (MD)
Entity Type:Individual
Prefix:DR
First Name:CINDERELLA
Middle Name:CHAVEZ
Last Name:RADU
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:399 E HIGHLAND AVE
Mailing Address - Street 2:SUITE 201
Mailing Address - City:SAN BERNARDINO
Mailing Address - State:CA
Mailing Address - Zip Code:92404-3808
Mailing Address - Country:US
Mailing Address - Phone:909-886-1900
Mailing Address - Fax:909-886-1910
Practice Address - Street 1:399 E HIGHLAND AVE
Practice Address - Street 2:SUITE 201
Practice Address - City:SAN BERNARDINO
Practice Address - State:CA
Practice Address - Zip Code:92404-3808
Practice Address - Country:US
Practice Address - Phone:909-886-1900
Practice Address - Fax:909-886-1910
Is Sole Proprietor?:No
Enumeration Date:2009-01-05
Last Update Date:2021-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS04-35696207RH0003X, 207RX0202X
CAC145467207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
No207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS200966240Medicaid
KS016701009OtherMEDICARE PTAN
OK200485260AMedicaid