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General NPI Number Information
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NPI Number | 1013068162
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Entity Type | Organization
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Legal Business Name | AVINASH M. MONDKAR M.D.,A MEDICAL CORPORATION
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Dates
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Enumeration Date | 01/16/2007
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Last Update Date | 09/10/2009
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Provider Practice Location Address
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Address Line | 1041 N CHINA LAKE BLVD SUITE A
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City | RIDGECREST
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State | CA
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Zip | 93555-3168
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Country | US
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Telephone | 310-657-1995
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Fax | 310-657-5311
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Provider Business Mailing Address
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Address Line | 8641 WILSHIRE BLVD #220
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City | BEVERLY HILLS
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State | CA
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Zip | 90211-2900
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Country | US
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Telephone | 310-657-1995
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Fax | 310-657-5311
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. AVINASH M. MONDKAR
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Credential | M.D.
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Telephone | 310-657-1995
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | A35142
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License Number State | CA
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