MEDICARE: MRS. HEMA KAMAL

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208100000X	Physical Medicine & Rehabilitation Physician	9880	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	236955	OTHER	CA	NBCOT

General Provider Information

NPI Number	:	1225640675
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. HEMA KAMAL

Provider Business Mailing Address
First Line	:	166 AVENIDA ESPANA
Second Line	:
City	:	SAN JOSE
State	:	CA
Zip	:	95139-1404
Country	:	US
Telephone Number	:	408-724-5701
Fax Number	:

Provider Business Practice Location Address
First Line	:	1049 EL MONTE AVE
Second Line	:
City	:	MOUNTAIN VIEW
State	:	CA
Zip	:	94040-2398
Country	:	US
Telephone Number	:	408-910-7167
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/18/2020
Last Update Date	:	08/18/2020

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