NPIMap

Organization Active NPI

West Valley Hematology Oncology Medical Group

  • Hematology & Oncology Physician
  • Northridge, CA
National Provider Identifier
1902108293
Registry record updated Jul 22, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
Legal business name
WEST VALLEY HEMATOLOGY ONCOLOGY MEDICAL GROUP
Practice address
18300 Roscoe Blvd
Leavey Cancer Center
Northridge, CA 91325-4105
Phone
(818) 700-2336
Fax
(818) 700-2337
NPI assigned
Nov 19, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2013

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

Authorized official

Name
Jerome Gary Davidson, MDNPI 1114926490
Title
Managing Partner
Phone
(818) 700-2336

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hematology & Oncology PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207RH0003X Primary

Addresses

Primary practice location

18300 Roscoe Blvd
Leavey Cancer Center
Northridge, CA 91325-4105

Mailing address

PO Box 11307
San Bernardino, CA 92423-1307
Phone (888) 344-9111

Other identifiers 1

IdentifierTypeStateIssuer
1902108293MedicaidCA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 5

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": "1290124800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1374451200000",
    "number": "1902108293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 11307",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924231307",
            "telephone_number": "888-344-9111",
            "fax_number": "909-335-7130"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18300 ROSCOE BLVD",
            "address_2": "LEAVEY CANCER CENTER",
            "city": "NORTHRIDGE",
            "state": "CA",
            "postal_code": "913254105",
            "telephone_number": "818-700-2336",
            "fax_number": "818-700-2337"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WEST VALLEY HEMATOLOGY ONCOLOGY MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-11-19",
        "last_updated": "2013-07-22",
        "status": "A",
        "authorized_official_last_name": "DAVIDSON",
        "authorized_official_first_name": "JEROME",
        "authorized_official_middle_name": "GARY",
        "authorized_official_title_or_position": "MANAGING PARTNER",
        "authorized_official_telephone_number": "818-700-2336",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1902108293",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Northridge, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2013; 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.