Provider Demographics
NPI:1033471867
Name:CENTRAL VALLEY RADIATION ONCOLOGY
Entity Type:Organization
Organization Name:CENTRAL VALLEY RADIATION ONCOLOGY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:AMARJIT
Authorized Official - Middle Name:S
Authorized Official - Last Name:DHALIWAL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:209-529-2000
Mailing Address - Street 1:1401 SPANOS CT
Mailing Address - Street 2:
Mailing Address - City:MODESTO
Mailing Address - State:CA
Mailing Address - Zip Code:95355-2810
Mailing Address - Country:US
Mailing Address - Phone:209-823-1609
Mailing Address - Fax:209-823-1655
Practice Address - Street 1:1401 SPANOS CT
Practice Address - Street 2:
Practice Address - City:MODESTO
Practice Address - State:CA
Practice Address - Zip Code:95355-2810
Practice Address - Country:US
Practice Address - Phone:209-823-1609
Practice Address - Fax:209-823-1655
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DHALIWAL MEDICAL ENTERPRISES, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-06-07
Last Update Date:2012-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QX0203XAmbulatory Health Care FacilitiesClinic/CenterOncology, Radiation