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General NPI Number Information
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NPI Number | 1205144813
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Entity Type | Organization
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Legal Business Name | PANKAJ M. KHEMKA, M.D., INC.
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Dates
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Enumeration Date | 09/16/2010
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Last Update Date | 09/16/2010
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Provider Practice Location Address
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Address Line | 1211 W LA PALMA AVE STE 410
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City | ANAHEIM
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State | CA
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Zip | 92801-2806
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Country | US
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Telephone | 714-288-8887
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Fax | 714-758-2927
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Provider Business Mailing Address
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Address Line | 480 N CHANDLER RANCH RD
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City | ORANGE
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State | CA
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Zip | 92869-4504
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Country | US
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Telephone | 714-288-8887
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Fax | 714-758-2927
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Authorized Official
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Title or Position | PRESIDENT
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Name | PANKAJ M. KHEMKA
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Credential | M.D.
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Telephone | 714-288-8887
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RI0200X
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Taxonomy Name | Infectious Disease Physician
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License Number | G75135
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License Number State | CA
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