Healthcare Provider Details

I. General information

NPI: 1467156828
Provider Name (Legal Business Name): SIVALINGAM MEDICAL CORPORATION, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/29/2023
Last Update Date: 03/29/2023
Certification Date: 03/29/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20111 W VALLEY BLVD
TEHACHAPI CA
93561-8747
US

IV. Provider business mailing address

44725 10TH ST W STE 170
LANCASTER CA
93534-3000
US

V. Phone/Fax

Practice location:
  • Phone: 661-822-3519
  • Fax: 661-822-3528
Mailing address:
  • Phone: 661-726-3724
  • Fax: 661-726-3770

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. KANAGARATNAM SIVALINGAM
Title or Position: PREDISENT
Credential: MD
Phone: 661-726-3724