Organization
SAN JOAQUIN HEMATOLOGY ONCOLOGY
Active
Other names
NEELESH S BANGALORE MD
Organization subpart
No
Provider details
NPI number
Authorized official
INMAN RENE GABRIELA (ADMINISTRATOR)
(209) 474-1458
Entity
Organization
Contact information
Practice address
1801 E MARCH LN, SUITE B260, STOCKTON, CA 95210-6629
(209) 474-1458
(209) 474-1444
Mailing address
PO BOX 7667, STOCKTON, CA 95267-0667
Taxonomy
Speciality
Code
Description
License number
State
332900000X
Non-Pharmacy Dispensing Site
Primary
A708830
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A708830
—
CA
01
—
5618371
OTHER ID NUMBER
—
Enumeration date
05/24/2006
Last updated
08/26/2011
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