Organization
VALLEY CANCER MEDICAL GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AMARJIT S DHALIWAL MD (MANAGING PARTNER)
(209) 823-1609
Entity
Organization
Contact information
Practice address
1401 SPANOS CT, #134, MODESTO, CA 95355
(209) 529-2000
(209) 525-3805
Mailing address
1401 SPANOS CT, #134, MODESTO, CA 95355
(209) 823-1609
(209) 823-1655
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
—
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR0072020
—
CA
01
—
ZZZ14597Z
PTAN
CA
Enumeration date
10/10/2006
Last updated
10/27/2015
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