Provider Demographics
NPI:1679760227
Name:BEVERLY ONCOLOGY & IMAGING CENTER MEDICAL GR
Entity type:Organization
Organization Name:BEVERLY ONCOLOGY & IMAGING CENTER MEDICAL GR
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:THROPAY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:323-724-8780
Mailing Address - Street 1:120 W BEVERLY BLVD
Mailing Address - Street 2:
Mailing Address - City:MONTEBELLO
Mailing Address - State:CA
Mailing Address - Zip Code:90640-4305
Mailing Address - Country:US
Mailing Address - Phone:323-724-8780
Mailing Address - Fax:323-728-9936
Practice Address - Street 1:1041 E YORBA LINDA BLVD STE 100
Practice Address - Street 2:
Practice Address - City:PLACENTIA
Practice Address - State:CA
Practice Address - Zip Code:92870-3762
Practice Address - Country:US
Practice Address - Phone:657-444-1164
Practice Address - Fax:657-208-9759
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BEVERLY ONCOLOGY & IMAGING CENTER MEDICAL GR
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-09-27
Last Update Date:2024-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA2085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation OncologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAW5769DMedicare PIN