MEDICARE: SOLANO HEMATOLOGY - ONCOLOGY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RH0003X	Hematology & Oncology Physician	A80619	CA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	DQ9008	OTHER		RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1528399193
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SOLANO HEMATOLOGY - ONCOLOGY

Provider Business Mailing Address
First Line	:	100 HOSPITAL DR
Second Line	:	SUITE 110
City	:	VALLEJO
State	:	CA
Zip	:	94589-2577
Country	:	US
Telephone Number	:	707-551-3300
Fax Number	:	707-551-3301

Provider Business Practice Location Address
First Line	:	100 HOSPITAL DR
Second Line	:	SUITE 110
City	:	VALLEJO
State	:	CA
Zip	:	94589-2577
Country	:	US
Telephone Number	:	707-551-3300
Fax Number	:	707-551-3301

Authorized Official
Title or Position	:	CEO
Name	:	DR. CHAINARONG LIMVARAPUSS
Credential	:	MD
Telephone Number	:	707-551-3300

Provider Enumeration Date	:	01/21/2010
Last Update Date	:	08/24/2021

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