CALIFORNIA ONCOLOGY MEDICAL GROUP OF TURLOCK INC. NPI 1578643490

NPI Information

NPI: 1578643490
Provider Name: CALIFORNIA ONCOLOGY MEDICAL GROUP OF TURLOCK, INC.
Classification: Internal Medicine - 207RH0003X
Entity Type: Organization

Specialization: Hematology & Oncology

CLIA Number: 05D2282280

Address:
880 E TUOLUMNE RD
103
TURLOCK, CA
ZIP 95382
Phone: (209) 669-8300
Get Directions

CALIFORNIA ONCOLOGY MEDICAL GROUP OF TURLOCK, INC. is a hematology and oncology internal medicine in Turlock, CA. The provider is an internist doctor of osteopathy that specializes in the treatment of the combination of hematology and oncology disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine WAS able to obtain a Certificate of Special Qualifications in the field of Hematology and Oncology. The Certificate is NO longer offered. CALIFORNIA ONCOLOGY MEDICAL GROUP OF TURLOCK, INC. NPI is 1578643490. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

880 E TUOLUMNE RD
103
TURLOCK, CA
ZIP 95382-548
Phone: (209) 669-8300
Fax: (209) 669-9300

The provider's authorized official is Mohamed Elsayed Eldaly .
The authorized official title is Director and has the following contact phone number (209) 669-8300.

The CLIA number assigned to this NPI record is 05D2282280 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 10/16/2006 and was last updated on 6/2/2008.

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	207RH0003X	Internal Medicine	Hematology & Oncology	J13239	MASSACHUSETTS	No
2	207RH0003X	Internal Medicine	Hematology & Oncology		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	J13239	MEDICARE ID-TYPE UNSPECIFIED	MASSACHUSETTS
2	GR0103970	MEDICAID	CALIFORNIA
3	F43852	MEDICARE UPIN	CALIFORNIA
4	ZZZ04289Z	MEDICARE PIN	CALIFORNIA
5	ZZZ67013Z	OTHER	CALIFORNIA	BLUE SHIELD
6	CE9729	MEDICARE PIN

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: 4/28/2024

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