Provider Demographics
NPI:1689316986
Name:MONTANA HEMEONCOLOGY LLC.
Entity Type:Organization
Organization Name:MONTANA HEMEONCOLOGY LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:WILBUR
Authorized Official - Middle Name:N
Authorized Official - Last Name:MONTANA
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:661-301-7494
Mailing Address - Street 1:4500 GOSFORD ROAD #106
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93313
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4500 GOSFORD ROAD #106
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93313
Practice Address - Country:US
Practice Address - Phone:661-301-7494
Practice Address - Fax:661-885-6088
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-04-08
Last Update Date:2022-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & OncologyGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty