Healthcare Provider Details

I. General information

NPI: 1861945115
Provider Name (Legal Business Name): HEMATOLOGY-ONCOLOGY MEDICAL GROUP OF S F VALLEY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/03/2016
Last Update Date: 01/19/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6850 SEPULVEDA BLVD SUITE 211
VAN NUYS CA
91405-4444
US

IV. Provider business mailing address

6850 SEPULVEDA BLVD SUITE 211
VAN NUYS CA
91405-4444
US

V. Phone/Fax

Practice location:
  • Phone: 818-994-0101
  • Fax: 818-902-5566
Mailing address:
  • Phone: 818-994-0101
  • Fax: 818-902-5566

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332900000X
TaxonomyNon-Pharmacy Dispensing Site
License Number
License Number State

VIII. Authorized Official

Name: DR. HOWARD G BERGER
Title or Position: PRESIDENT
Credential: M.D.
Phone: 310-445-2800