Provider Demographics
NPI:1174843239
Name:ISLANDVIEW HEMATOLOGY ONCOLOGY MED GRP INC.
Entity Type:Organization
Organization Name:ISLANDVIEW HEMATOLOGY ONCOLOGY MED GRP INC.
Other - Org Name:STEPHEN V. RIGBERG
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JU;IA
Authorized Official - Middle Name:B
Authorized Official - Last Name:VALDIVIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:805-981-0808
Mailing Address - Street 1:1901 SOLAR DR
Mailing Address - Street 2:240
Mailing Address - City:OXNARD
Mailing Address - State:CA
Mailing Address - Zip Code:93036-2641
Mailing Address - Country:US
Mailing Address - Phone:805-981-0808
Mailing Address - Fax:805-981-0430
Practice Address - Street 1:1901 SOLAR DR
Practice Address - Street 2:240
Practice Address - City:OXNARD
Practice Address - State:CA
Practice Address - Zip Code:93036-2641
Practice Address - Country:US
Practice Address - Phone:805-981-0808
Practice Address - Fax:805-981-0430
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-10
Last Update Date:2010-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG308702207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAG30872Medicare PIN
CAA44580Medicare UPIN