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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 (CEO)
(209) 477-2000
Entity
Organization
Contact information
Practice address
4600 S TRACY BLVD STE 108, TRACY, CA 95377-8105
(209) 839-9115
Mailing address
PO BOX 7667, STOCKTON, CA 95267-0667
(209) 477-2000
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
A70883
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00A708831
MEDI-CAL
CA
05
—
00A708832
—
CA
01
—
A708830
MEDICARE
CA
01
—
DC7234
RAILROAD MEDICARE
CA
01
—
P00186385
RAILROAD MEDICARE
CA
01
—
ZZZ08571Z
BLUE SHIELD
CA
Enumeration date
03/15/2006
Last updated
04/20/2008
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