San Joaquin Hematology Oncology

Primary specialty

Non-Pharmacy Dispensing SiteTaxonomy code 332900000X

License

A708830 Issued in CA

Legal business name

SAN JOAQUIN HEMATOLOGY ONCOLOGY

Practice address

1801 E March LN
Suite B260
Stockton, CA 95210-6629

Phone

(209) 474-1458

Fax

(209) 474-1444

NPI assigned

May 24, 2006

Organization subpart

No

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

Authorized official

Name

Inman Rene Gabriela

Title

Administrator

Phone

(209) 474-1458

Specialties & licenses 1

Addresses

Other identifiers 3

Other names 1

• NEELESH S BANGALORE MD Doing business as

Locations

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

{
    "created_epoch": "1148428800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1314316800000",
    "number": "1952356909",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7667",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952670667"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1801 E MARCH LN",
            "address_2": "SUITE B260",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952106629",
            "telephone_number": "209-474-1458",
            "fax_number": "209-474-1444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAN JOAQUIN HEMATOLOGY ONCOLOGY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-24",
        "last_updated": "2011-08-26",
        "status": "A",
        "authorized_official_last_name": "GABRIELA",
        "authorized_official_first_name": "INMAN",
        "authorized_official_middle_name": "RENE",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "209-474-1458"
    },
    "taxonomies": [
        {
            "code": "332900000X",
            "taxonomy_group": "",
            "desc": "Non-Pharmacy Dispensing Site",
            "state": "CA",
            "license": "A708830",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A708830",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER",
            "identifier": "5618371",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER-COMMERCIAL NUMBER",
            "identifier": "5618371",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "NEELESH S BANGALORE MD",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• San Joaquin County Office of Education
• San Joaquin County Public Health Services
• San Joaquin County Public Health Waiver
• San Joaquin Critical Care Medical Group, Inc.
• San Joaquin Hearing
• San Joaquin Hematology Oncology a PC
• San Joaquin Hematology/Oncology a Professional Corp
• San Joaquin Kidney Clinic, Inc
• San Joaquin Laser and Surgery Center
• San Joaquin Laser Surgery Center

• Non-Pharmacy Dispensing Site in Stockton, CA
• Providers in Stockton, CA by specialty
• Non-Pharmacy Dispensing Site in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2011; 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.