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General NPI Number Information
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NPI Number | 1720035561
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Entity Type | Organization
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Legal Business Name | GRASS VALLEY HEMATOLOGY/ONCOLOGY MED GRP
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Dates
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Enumeration Date | 05/27/2006
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Last Update Date | 08/26/2010
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Provider Practice Location Address
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Address Line | 155 GLASSON WAY SUITE L10
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City | GRASS VALLEY
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State | CA
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Zip | 95945-5723
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Country | US
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Telephone | 530-274-6677
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Fax | 530-274-6678
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Provider Business Mailing Address
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Address Line | PO BOX 1549
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City | GRASS VALLEY
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State | CA
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Zip | 95945-1549
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Country | US
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Telephone | 530-274-6677
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Fax | 530-274-6678
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Authorized Official
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Title or Position | PARTNER
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Name | DR. DAVID LAWRENCE CAMPBELL
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Credential | M.D.
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Telephone | 530-274-6677
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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 |
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