Provider Demographics
NPI:1992712699
Name:ORANGE COUNTY RADIATION ONCOLOGY MEDICAL GROUP
Entity type:Organization
Organization Name:ORANGE COUNTY RADIATION ONCOLOGY MEDICAL GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CHU-PEI
Authorized Official - Middle Name:
Authorized Official - Last Name:FENG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:714-835-8520
Mailing Address - Street 1:1100 N TUSTIN AVE STE A
Mailing Address - Street 2:
Mailing Address - City:SANTA ANA
Mailing Address - State:CA
Mailing Address - Zip Code:92705-3509
Mailing Address - Country:US
Mailing Address - Phone:714-835-8520
Mailing Address - Fax:148-353-6107
Practice Address - Street 1:1100 N TUSTIN AVE STE A
Practice Address - Street 2:
Practice Address - City:SANTA ANA
Practice Address - State:CA
Practice Address - Zip Code:92705-3509
Practice Address - Country:US
Practice Address - Phone:714-835-8520
Practice Address - Fax:714-835-3610
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-02
Last Update Date:2021-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation OncologyGroup - Single Specialty
No174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAGR0098520Medicaid
CAGR0098521Medicaid
CAGR0098521Medicaid