Provider Demographics
NPI:1528399193
Name:SOLANO HEMATOLOGY - ONCOLOGY
Entity Type:Organization
Organization Name:SOLANO HEMATOLOGY - ONCOLOGY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:CHAINARONG
Authorized Official - Middle Name:
Authorized Official - Last Name:LIMVARAPUSS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:707-551-3300
Mailing Address - Street 1:100 HOSPITAL DR
Mailing Address - Street 2:SUITE 110
Mailing Address - City:VALLEJO
Mailing Address - State:CA
Mailing Address - Zip Code:94589-2577
Mailing Address - Country:US
Mailing Address - Phone:707-551-3300
Mailing Address - Fax:707-551-3301
Practice Address - Street 1:100 HOSPITAL DR
Practice Address - Street 2:SUITE 110
Practice Address - City:VALLEJO
Practice Address - State:CA
Practice Address - Zip Code:94589-2577
Practice Address - Country:US
Practice Address - Phone:707-551-3300
Practice Address - Fax:707-551-3301
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-21
Last Update Date:2021-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA80619207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & OncologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
DQ9008OtherRAILROAD MEDICARE
CA1528399193Medicaid
6475140001Medicare NSC
DJ904AMedicare UPIN