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General NPI Number Information
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NPI Number | 1043208457
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Entity Type | Organization
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Legal Business Name | NORTHERN CALIFORNIA HEMATOLOGY AND ONCOLOGY CONSULTANTS, INC
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Dates
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Enumeration Date | 10/10/2005
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Last Update Date | 11/08/2019
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Provider Practice Location Address
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Address Line | 2001 DWIGHT WAY
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City | BERKELEY
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State | CA
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Zip | 94704-2608
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Country | US
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Telephone | 510-204-6402
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Fax | 510-848-0801
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Provider Business Mailing Address
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Address Line | 2001 DWIGHT WAY
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City | BERKELEY
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State | CA
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Zip | 94704-2608
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Country | US
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Telephone | 510-204-6402
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Fax | 510-848-0801
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Authorized Official
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Title or Position | MD/EXECUTIVE DIRECTOR
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Name | DR. GARY CECCHI
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Credential | M.D.
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Telephone | 510-204-6402
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207RH0003X
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Taxonomy Name | Hematology & Oncology Physician
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License Number |
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License Number State |
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