Healthcare Provider Details

I. General information

NPI: 1013150911
Provider Name (Legal Business Name): LOS PALOS ONCOLOGY AND HEMATOLOGY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/08/2009
Last Update Date: 08/26/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

505 E ROMIE LN STE A
SALINAS CA
93901-4031
US

IV. Provider business mailing address

505 E ROMIE LN STE A
SALINAS CA
93901-4031
US

V. Phone/Fax

Practice location:
  • Phone: 831-755-1701
  • Fax: 831-755-1702
Mailing address:
  • Phone: 831-755-1701
  • Fax: 831-755-1702

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License NumberG60252
License Number StateCA

VIII. Authorized Official

Name: DR. LAURA STAMPLEMAN
Title or Position: PRESIDENT
Credential: M.D.
Phone: 831-755-1701