Provider Demographics
NPI:1669669586
Name:JOHN KIRALY MD
Entity Type:Organization
Organization Name:JOHN KIRALY MD
Other - Org Name:DELTA- SIERRA HEMATOLOGY & ONCOLOGY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:FLORIAN
Authorized Official - Last Name:KIRALY
Authorized Official - Suffix:II
Authorized Official - Credentials:MD
Authorized Official - Phone:209-334-1614
Mailing Address - Street 1:2407 W VINE ST STE A
Mailing Address - Street 2:
Mailing Address - City:LODI
Mailing Address - State:CA
Mailing Address - Zip Code:95242-3730
Mailing Address - Country:US
Mailing Address - Phone:209-334-1614
Mailing Address - Fax:209-334-0115
Practice Address - Street 1:2407 W VINE ST STE A
Practice Address - Street 2:
Practice Address - City:LODI
Practice Address - State:CA
Practice Address - Zip Code:95242-3730
Practice Address - Country:US
Practice Address - Phone:209-334-1614
Practice Address - Fax:209-334-0115
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-25
Last Update Date:2008-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA24190261QI0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QI0500XAmbulatory Health Care FacilitiesClinic/CenterInfusion Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA23846Medicare UPIN
CA8950426Medicare PIN