Provider Demographics
NPI:1861945115
Name:HEMATOLOGY-ONCOLOGY MEDICAL GROUP OF S F VALLEY
Entity type:Organization
Organization Name:HEMATOLOGY-ONCOLOGY MEDICAL GROUP OF S F VALLEY
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:HOWARD
Authorized Official - Middle Name:G
Authorized Official - Last Name:BERGER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:310-445-2800
Mailing Address - Street 1:6850 SEPULVEDA BLVD
Mailing Address - Street 2:SUITE 211
Mailing Address - City:VAN NUYS
Mailing Address - State:CA
Mailing Address - Zip Code:91405-4444
Mailing Address - Country:US
Mailing Address - Phone:818-994-0101
Mailing Address - Fax:818-902-5566
Practice Address - Street 1:6850 SEPULVEDA BLVD
Practice Address - Street 2:SUITE 211
Practice Address - City:VAN NUYS
Practice Address - State:CA
Practice Address - Zip Code:91405-4444
Practice Address - Country:US
Practice Address - Phone:818-994-0101
Practice Address - Fax:818-902-5566
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-03
Last Update Date:2017-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332900000XSuppliersNon-Pharmacy Dispensing Site
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA7572390001Medicare NSC