Provider Demographics
NPI:1467437848
Name:INLAND HEMATOLOGY-ONCOLOGY MEDICAL GROUP INC
Entity type:Organization
Organization Name:INLAND HEMATOLOGY-ONCOLOGY MEDICAL GROUP INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RAJIV
Authorized Official - Middle Name:
Authorized Official - Last Name:MALIK
Authorized Official - Suffix:
Authorized Official - Credentials:M D
Authorized Official - Phone:909-886-6806
Mailing Address - Street 1:401 E HIGHLAND AVE STE C
Mailing Address - Street 2:
Mailing Address - City:SAN BERNARDINO
Mailing Address - State:CA
Mailing Address - Zip Code:92404-3834
Mailing Address - Country:US
Mailing Address - Phone:909-886-6806
Mailing Address - Fax:909-883-8132
Practice Address - Street 1:401 E HIGHLAND AVE STE C
Practice Address - Street 2:
Practice Address - City:SAN BERNARDINO
Practice Address - State:CA
Practice Address - Zip Code:92404-3834
Practice Address - Country:US
Practice Address - Phone:909-886-6806
Practice Address - Fax:909-883-8132
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-12-08
Last Update Date:2023-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA52073207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & OncologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CACP2041OtherRAILROAD MEDICARE
CAZZZ80927Z22Medicaid
CAZZZ80927Z22Medicaid