# PEDIATRIC HEMATOLOGY ONCOLOGY

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1760549141
- **Authorized official:** ELLIOTT VICHINSKY M.D. (PARTNER)
- **Authorized official phone:** (510) 428-3855

## Contact information

- **Practice address:** 747 52ND ST, OAKLAND, CA 94609-1809
- **Practice address phone:** (510) 428-3885
- **Mailing address:** 5528 PACHECO BLVD, \#A, PACHECO, CA 94553-5126
- **Mailing address phone:** (925) 363-8170

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2080P0207X | Pediatric Hematology & Oncology Physician | ZZZ77127Z | CA | Yes |

## Other

- **Enumeration date:** 01/03/2007
- **Last updated:** 08/23/2013