Provider Demographics
NPI:1326350950
Name:VALLEY ONCOLOGY, P.C.
Entity Type:Organization
Organization Name:VALLEY ONCOLOGY, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:LESLIE
Authorized Official - Middle Name:E
Authorized Official - Last Name:BOTNICK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:310-335-4000
Mailing Address - Street 1:1500 ROSECRANS AVE
Mailing Address - Street 2:400
Mailing Address - City:MANHATTAN BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90266-3763
Mailing Address - Country:US
Mailing Address - Phone:310-335-4000
Mailing Address - Fax:310-335-4096
Practice Address - Street 1:5522 SEPULVEDA BLVD
Practice Address - Street 2:
Practice Address - City:SHERMAN OAKS
Practice Address - State:CA
Practice Address - Zip Code:91411-3437
Practice Address - Country:US
Practice Address - Phone:818-997-1522
Practice Address - Fax:818-997-0705
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-07-12
Last Update Date:2010-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation OncologyGroup - Single Specialty