Healthcare Provider Details

I. General information

NPI: 1316996002
Provider Name (Legal Business Name): SADHANA PANDURANGA KAMATH M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/09/2006
Last Update Date: 10/21/2021
Certification Date: 10/21/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

41230 11TH ST W STE B
PALMDALE CA
93551-1411
US

IV. Provider business mailing address

41230 11TH ST W STE B
PALMDALE CA
93551-1411
US

V. Phone/Fax

Practice location:
  • Phone: 661-272-1400
  • Fax: 661-272-9499
Mailing address:
  • Phone: 661-272-1400
  • Fax: 661-272-9499

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberA53268
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: