Healthcare Provider Details

I. General information

NPI: 1528399193
Provider Name (Legal Business Name): SOLANO HEMATOLOGY - ONCOLOGY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/21/2010
Last Update Date: 08/24/2021
Certification Date: 08/24/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 HOSPITAL DR SUITE 110
VALLEJO CA
94589-2577
US

IV. Provider business mailing address

100 HOSPITAL DR SUITE 110
VALLEJO CA
94589-2577
US

V. Phone/Fax

Practice location:
  • Phone: 707-551-3300
  • Fax: 707-551-3301
Mailing address:
  • Phone: 707-551-3300
  • Fax: 707-551-3301

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License NumberA80619
License Number StateCA

VIII. Authorized Official

Name: DR. CHAINARONG LIMVARAPUSS
Title or Position: CEO
Credential: MD
Phone: 707-551-3300