Active NPI
Valley Cancer Medical Group
- Hematology & Oncology Physician
- Modesto, CA
National Provider Identifier
1063500833
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Hematology & Oncology Physician
- 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
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Hematology & Oncology Physician | 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| ZZZ14597Z | Other | CA | PTAN |
| GR0072020 | Medicaid | CA |
National Provider Directory
National Provider DirectoryLocations
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.
-
- Hematology & Oncology Physician
- Merced, CA
- NPI 1710229380
-
- Hematology & Oncology Physician
- Newport News, VA
- NPI 1518128222
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.