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General NPI Number Information
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NPI Number | 1063500833
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Entity Type | Organization
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Legal Business Name | VALLEY CANCER MEDICAL GROUP
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Dates
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Enumeration Date | 10/10/2006
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Last Update Date | 10/27/2015
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Provider Practice Location Address
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Address Line | 1401 SPANOS CT #134
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City | MODESTO
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State | CA
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Zip | 95355
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Country | US
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Telephone | 209-529-2000
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Fax | 209-525-3805
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Provider Business Mailing Address
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Address Line | 1401 SPANOS CT #134
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City | MODESTO
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State | CA
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Zip | 95355
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Country | US
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Telephone | 209-823-1609
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Fax | 209-823-1655
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Authorized Official
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Title or Position | MANAGING PARTNER
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Name | AMARJIT S DHALIWAL
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Credential | MD
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Telephone | 209-823-1609
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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 | CA
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