1639109457 NPI number — HEMATOLOGY-ONCOLOGY CONSULTANTS

Table of content: (NPI 1639109457)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1639109457 NPI number — HEMATOLOGY-ONCOLOGY CONSULTANTS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HEMATOLOGY-ONCOLOGY CONSULTANTS
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1639109457
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/09/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
301 N SAN JACINTO ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HEMET
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
92543-3119
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
951-766-6460
Provider Business Mailing Address Fax Number:
951-766-6459

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
301 N SAN JACINTO ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HEMET
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92543-3119
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
951-766-6460
Provider Business Practice Location Address Fax Number:
951-766-6459
Provider Enumeration Date:
07/04/2006

Additional Information

Authorized Official

Authorized Official Last Name:
SCHINKE
Authorized Official First Name:
STANLEY
Authorized Official Middle Name:
D
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
951-766-6460

Provider Taxonomy Codes

  • Taxonomy code: 174400000X , with the licence number:  G559890 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 00A486110 , issued by the state of ( CA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1558368605 . This is a "EVELYN MENDOZA MD NPI" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".
  • Identifier: 1649277088 . This is a "STANLEY SCHINKE MD NPI" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".
  • Identifier: 1689671034 . This is a "KISHORE SEHGAL MD NPI" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".
  • Identifier: 00G559890 , issued by the state of ( CA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1457545840 . This is a "MEDICARE PART B DME" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".
  • Identifier: 05D1062719 . This is a "CLIA NUMBER" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".
  • Identifier: 1962696344 . This is a "MEDICARE PART B DME" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".
  • Identifier: 00A424840 , issued by the state of ( CA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1225222029 . This is a "MEDICARE PART B DME" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".
  • Identifier: 1558555938 . This is a "MEDICARE PART B DME" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".




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