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NPI Code Detail

MEDICARE: EAST BAY MEDICAL ONCOLOGY-HEMATOLOGY ASSOCIATES, INC.

MEDICARE: EAST BAY MEDICAL ONCOLOGY-HEMATOLOGY ASSOCIATES, 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 PhysicianA36088CA

General Provider Information

NPI Number : 1932107331
Entity Type Code : Organization
Provider Name (Legal Business Name) : EAST BAY MEDICAL ONCOLOGY-HEMATOLOGY ASSOCIATES, INC.
Provider Business Mailing Address
First Line : 4721 DALLAS RANCH ROAD
Second Line :
City : ANTIOCH
State : CA
Zip : 94531-8811
Country : US
Telephone Number : 925-778-0679
Fax Number : 925-778-3567
Provider Business Practice Location Address
First Line : 4721 DALLAS RANCH RD
Second Line :
City : ANTIOCH
State : CA
Zip : 94531-8811
Country : US
Telephone Number : 925-778-0679
Fax Number : 925-778-3567
Authorized Official
Title or Position : PARTNER
Name : DR. JOHN T GANEY
Credential : M.D.
Telephone Number : 925-687-2570
Provider Enumeration Date : 07/08/2005
Last Update Date : 12/14/2010

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