Healthcare Provider Details
I. General information
NPI: 1972675593
Provider Name (Legal Business Name): CALIFORNIA ONCOLOGY OF THE CENTRAL VALLEY MEDICAL GROUP INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 11/15/2006
Last Update Date: 01/04/2013
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
6121 N THESTA ST STE 204
FRESNO CA
93710-8603
US
IV. Provider business mailing address
6121 N THESTA ST 204
FRESNO CA
93710-8603
US
V. Phone/Fax
- Phone: 559-438-7390
- Fax: 559-438-7166
- Phone: 559-438-7390
- Fax: 559-438-7166
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207RH0003X |
| Taxonomy | Hematology & Oncology Physician |
| License Number | |
| License Number State | CA |
VIII. Authorized Official
Name: DR.
CHRISTOPHER
R
PERKINS
Title or Position: PRESIDENT
Credential: MD
Phone: 559-438-7390