Healthcare Provider Details

I. General information

NPI: 1487664439
Provider Name (Legal Business Name): VALLEY HEMATOLOGY ONCOLOGY MEDICAL GROUP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/09/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7320 WOODLAKE AVE 330
WEST HILLS CA
91307-1468
US

IV. Provider business mailing address

7320 WOODLAKE AVE 330
WEST HILLS CA
91307-1468
US

V. Phone/Fax

Practice location:
  • Phone: 818-346-1773
  • Fax: 818-346-3010
Mailing address:
  • Phone: 818-346-1773
  • Fax: 818-346-3010

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: BRUCE ZIETZ
Title or Position: OWNER
Credential: M.D.
Phone: 818-346-1773