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NPI Code Detail

MEDICARE: EASTBAY HEMATOLOGY/ONCOLOGY CONSULTANTS, INC

MEDICARE: EASTBAY HEMATOLOGY/ONCOLOGY CONSULTANTS, INC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207RH0003XHematology & Oncology Physician

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1700874120
Entity Type Code : Organization
Provider Name (Legal Business Name) : EASTBAY HEMATOLOGY/ONCOLOGY CONSULTANTS, INC
Provider Business Mailing Address
First Line : 2001 DWIGHT WAY
Second Line :
City : BERKELEY
State : CA
Zip : 94704-2608
Country : US
Telephone Number : 510-204-6402
Fax Number : 510-848-0801
Provider Business Practice Location Address
First Line : 2000 VALE RD
Second Line :
City : SAN PABLO
State : CA
Zip : 94806-3808
Country : US
Telephone Number : 510-204-6402
Fax Number : 510-848-0801
Authorized Official
Title or Position : MD/AUTHORIZED OFFICIAL
Name : DR. GARY CECCHI
Credential : M.D.
Telephone Number : 510-204-6024
Provider Enumeration Date : 10/10/2005
Last Update Date : 03/16/2010

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