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Organization
SAN JOAQUIN HEMATOLOGY ONCOLOGY A PC
Active
Organization
SAN JOAQUIN HEMATOLOGY ONCOLOGY A PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. NEELESH S BANGALORE MD, PHD (PRESIDENT)
(209) 839-9115
Entity
Organization
Contact information
Practice address
4600 S TRACY BLVD STE 108, TRACY, CA 95377-8105
(209) 839-9115
(209) 833-7262
Mailing address
PO BOX 7667, STOCKTON, CA 95267-0667
(209) 839-9115
(209) 833-7262
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
A70883
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5337360001
DMERC NUMBER
CA
Enumeration date
05/15/2007
Last updated
07/23/2008
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