NPIMap

Organization Active NPI

Valley Cancer Medical Center Inc

  • Specialist
  • Manteca, CA
National Provider Identifier
1740648856
Registry record updated Oct 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
A137447 Issued in CA
Legal business name
VALLEY CANCER MEDICAL CENTER INC
Practice address
1138 Norman Dr
Ste 101
Manteca, CA 95336-5965
Phone
(209) 823-1609
Fax
(209) 823-1655
NPI assigned
Feb 3, 2016
Last updated
Oct 11, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 11, 2023

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

Authorized official

Name
Dr. Amarjit Singh Dhaliwal, MDNPI 1922019322
Title
Ceo/MD
Phone
(209) 823-1609

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X A49314 CA
Specialist 174400000X A130901 CA
Specialist 174400000X C39275 CA
Specialist 174400000X A137447 CA Primary

Addresses

Primary practice location

1138 Norman Dr
Ste 101
Manteca, CA 95336-5965

Mailing address

1138 Norman Dr
Ste 101
Manteca, CA 95336-5965
Phone (209) 823-1609

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20161021000086 CA Part B Supplier - Clinic/Group Practice 7517245863 Receives reassigned benefits from 5 practitioners
Practice locations: Manteca, CA

National Provider Directory

National Provider Directory

Locations

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

1138 Norman Dr
Ste 101
Manteca, CA 95336
Phone (209) 823-1609

1401 Spanos Ct
Ste 134
Modesto, CA 95355
Phone (209) 529-2000

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1454457600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1696982400000",
    "number": "1740648856",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1138 NORMAN DR",
            "address_2": "STE 101",
            "city": "MANTECA",
            "state": "CA",
            "postal_code": "953365965",
            "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": "1138 NORMAN DR",
            "address_2": "STE 101",
            "city": "MANTECA",
            "state": "CA",
            "postal_code": "953365965",
            "telephone_number": "209-823-1609",
            "fax_number": "209-823-1655"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VALLEY CANCER MEDICAL CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-02-03",
        "last_updated": "2023-10-11",
        "certification_date": "2023-10-11",
        "status": "A",
        "authorized_official_last_name": "DHALIWAL",
        "authorized_official_first_name": "AMARJIT",
        "authorized_official_middle_name": "SINGH",
        "authorized_official_title_or_position": "CEO/MD",
        "authorized_official_telephone_number": "209-823-1609",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CA",
            "license": "A49314",
            "primary": false
        },
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CA",
            "license": "A130901",
            "primary": false
        },
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CA",
            "license": "C39275",
            "primary": false
        },
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CA",
            "license": "A137447",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Manteca, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.