SAN JOAQUIN HEMATOLOGY/ONCOLOGY A PROFESSIONAL CORP NPI 1578515045

NPI Information

NPI: 1578515045
Provider Name: SAN JOAQUIN HEMATOLOGY/ONCOLOGY A PROFESSIONAL CORP
Classification: Specialist - 174400000X
Entity Type: Organization
Address:
1801 E MARCH LN STE B260
STOCKTON, CA
ZIP 95210
Phone: (209) 474-1458
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SAN JOAQUIN HEMATOLOGY/ONCOLOGY A PROFESSIONAL CORP is a specialist in Stockton, CA. The provider is an individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. SAN JOAQUIN HEMATOLOGY/ONCOLOGY A PROFESSIONAL CORP NPI is 1578515045. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

1801 E MARCH LN STE B260
STOCKTON, CA
ZIP 95210-655
Phone: (209) 474-1458
Fax: (209) 474-1444

The provider's authorized official is Neelesh Bangalore .
The authorized official title is Ceo and has the following contact phone number (209) 839-9115.

The enumeration date for this NPI number is 5/16/2006 and was last updated on 4/29/2016.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	174400000X	Specialist		A70883	CALIFORNIA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	DC7234	OTHER	CALIFORNIA	RAILROAD MEDICARE
2	00A708832	OTHER	CALIFORNIA	MEDI-CAL
3	ZZZ29366Z	MEDICARE PIN	CALIFORNIA
4	=========	OTHER	CALIFORNIA	TAX ID
5	H25351	MEDICARE UPIN	CALIFORNIA
6	P00186385	OTHER	CALIFORNIA	RAILROAD MEDICARE
7	00A708831	MEDICAID	CALIFORNIA
8	00A708830	OTHER	CALIFORNIA	MEDICARE
9	ZZZ08571Z	OTHER	CALIFORNIA	BLUE SHIELD

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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