Provider Demographics
NPI:1598987133
Name:GARFIELD HEMATOLOGY & ONCOLOGY CONSULTANS MEDICAL GROUP
Entity Type:Organization
Organization Name:GARFIELD HEMATOLOGY & ONCOLOGY CONSULTANS MEDICAL GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:SETSUKO
Authorized Official - Middle Name:
Authorized Official - Last Name:BANKS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:626-573-5000
Mailing Address - Street 1:600 NORTH GARFIELD AVENUE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:MONTEREY PARK
Mailing Address - State:CA
Mailing Address - Zip Code:91754
Mailing Address - Country:US
Mailing Address - Phone:626-573-5000
Mailing Address - Fax:626-573-5001
Practice Address - Street 1:600 NORTH GARFIELD AVENUE
Practice Address - Street 2:SUITE 200
Practice Address - City:MONTEREY PARK
Practice Address - State:CA
Practice Address - Zip Code:91754
Practice Address - Country:US
Practice Address - Phone:626-573-5000
Practice Address - Fax:626-573-5001
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA545830291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
CALAB63660FMedicaid