Provider Demographics
NPI:1588023295
Name:HEMATOLOGY ONCOLOGY CONSULTANTS
Entity Type:Organization
Organization Name:HEMATOLOGY ONCOLOGY CONSULTANTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLER
Authorized Official - Prefix:
Authorized Official - First Name:ERIN
Authorized Official - Middle Name:
Authorized Official - Last Name:GARRETT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:951-766-6460
Mailing Address - Street 1:301 N SAN JACINTO ST
Mailing Address - Street 2:
Mailing Address - City:HEMET
Mailing Address - State:CA
Mailing Address - Zip Code:92543-3119
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:28078 BAXTER RD
Practice Address - Street 2:STE 140
Practice Address - City:MURRIETA
Practice Address - State:CA
Practice Address - Zip Code:92563-1402
Practice Address - Country:US
Practice Address - Phone:951-252-9600
Practice Address - Fax:951-252-9699
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HEMATOLOGY ONCOLOGY CONSULTANTS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2016-02-23
Last Update Date:2016-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA00G55989174400000X
CAA42484174400000X
CAG05779174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
1689671034OtherNPI
1649277088OtherNPI
1558368605OtherNPI
1639109457OtherNPI