Healthcare Provider Details

I. General information

NPI: 1023476579
Provider Name (Legal Business Name): HIRAL AMIN TANK MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/28/2016
Last Update Date: 08/05/2025
Certification Date: 08/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5701 WINTERBROOKE AVE
DUBLIN CA
94568
US

IV. Provider business mailing address

5701 WINTERBROOKE AVE
DUBLIN CA
94568
US

V. Phone/Fax

Practice location:
  • Phone: 732-322-7935
  • Fax:
Mailing address:
  • Phone: 732-322-7935
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number04-50783
License Number StateKS
# 3
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number55525
License Number StateKY
# 4
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number17402
License Number StateSD
# 5
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberA196510
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: