Organization
WEST VALLEY HEMATOLOGY ONCOLOGY MEDICAL GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEROME GARY DAVIDSON MD (MANAGING PARTNER)
(818) 700-2336
Entity
Organization
Contact information
Practice address
18300 ROSCOE BLVD, LEAVEY CANCER CENTER, NORTHRIDGE, CA 91325-4105
(818) 700-2336
(818) 700-2337
Mailing address
PO BOX 11307, SAN BERNARDINO, CA 92423-1307
(888) 344-9111
(909) 335-7130
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1902108293
—
CA
Enumeration date
11/19/2010
Last updated
07/22/2013
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