Organization Active NPI

Valley Cancer Medical Group

  • Hematology & Oncology Physician
  • Modesto, CA
National Provider Identifier
1063500833
Registry record updated Oct 27, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
Legal business name
VALLEY CANCER MEDICAL GROUP
Practice address
1401 Spanos CT
#134
Modesto, CA 95355
Phone
(209) 529-2000
Fax
(209) 525-3805
NPI assigned
Oct 10, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 27, 2015

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Amarjit S Dhaliwal, MD
Title
Managing Partner
Phone
(209) 823-1609

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hematology & Oncology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RH0003X CA Primary

Addresses

Primary practice location

1401 Spanos CT
#134
Modesto, CA 95355

Mailing address

1401 Spanos CT
#134
Modesto, CA 95355
Phone (209) 823-1609

Other identifiers 2

IdentifierTypeStateIssuer
ZZZ14597ZOtherCAPTAN
GR0072020MedicaidCA

National Provider Directory

National Provider Directory

Locations

1138 Norman Dr
Ste 1
Manteca, CA 95336
Phone (209) 823-1609

2161 Colorado Ave
Ste A2
Turlock, CA 95382
Phone (209) 632-2368

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1160438400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1445904000000",
    "number": "1063500833",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1401 SPANOS CT",
            "address_2": "#134",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "95355",
            "telephone_number": "209-823-1609",
            "fax_number": "209-823-1655"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 SPANOS CT",
            "address_2": "#134",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "95355",
            "telephone_number": "209-529-2000",
            "fax_number": "209-525-3805"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VALLEY CANCER MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-10",
        "last_updated": "2015-10-27",
        "status": "A",
        "authorized_official_last_name": "DHALIWAL",
        "authorized_official_first_name": "AMARJIT",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "MANAGING PARTNER",
        "authorized_official_telephone_number": "209-823-1609",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "ZZZ14597Z",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0072020",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Modesto, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.