Unknown Individual – Radiation Oncology Physician, NPI 1972546695

Unknown Individual is a healthcare provider. based in Tiburon, California. specializing in Radiation Oncology Physician. They hold a License No. C28372 (CA). The NPI Number for Unknown Individual is 1972546695

Main info

Organization
Inactive
61 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1972546695
Phone
(209) 327-2225
Address
159 SAINT THOMAS WAY
Deactivation Date
26 December 2024

Doctor Profile

Medical School Name
UNIVERSITY OF MISSOURI, COLUMBIA SCHOOL OF MEDICINE
Secondary Phone
7145739500
Graduation Year
1965 (61 years ago)
PAC ID
2264486570
Group Practice PAC ID
9830235217
Professional Enrollment ID
I20050309000905
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience14
Completeness75
Years active:0State licenses:1Digital endpointsOther names

Provider Addresses for Unknown Individual

  • 159 SAINT THOMAS WAY

    TIBURON, CA 949201031

    Phone: (209) 327-2225

    Fax: (415) 937-5053

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

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Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

No Medicare enrollment or revalidation data available for this provider in our database.

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Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 94920)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 9830235217View full group profile
NameSpecialtyState
Radiation OncologyMO
Radiation OncologyWA
Radiation OncologyIL
Radiation OncologyCA

Reviews

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Frequently asked questions

What number should I use to identify Unknown Individual for billing?
Administrative and clinical systems typically use NPI 1972546695 for Unknown Individual.
What happens when Unknown Individual's NPI is not active?
Public data lists Unknown Individual outside the active bucket for this identifier.
Which specialty label fits Unknown Individual?
NPPES ties Unknown Individual to Radiation Oncology Physician in the taxonomy section. Clinical services aligned with this taxonomy classification.
What city is tied to Unknown Individual?
The directory associates Unknown Individual with Tiburon, California. Check all listed addresses for suites or satellite offices.
Why is information missing for Unknown Individual?
Providers choose how much contact data to publish. Missing fields do not mean the profile is fake.

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