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General NPI Number Information
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NPI Number | 1457511628
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Entity Type | Individual
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Provider Name | AMOD TENDULKAR MD
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Gender | Male
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Dates
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Enumeration Date | 06/11/2008
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Last Update Date | 02/04/2022
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Provider Practice Location Address
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Address Line | 710 LAWRENCE EXPY DEPT 342
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City | SANTA CLARA
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State | CA
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Zip | 95051-5173
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Country | US
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Telephone | 408-851-3779
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Fax | 408-851-3862
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Provider Business Mailing Address
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Address Line | 710 LAWRENCE EXPY DEPT 342
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City | SANTA CLARA
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State | CA
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Zip | 95051-5173
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Country | US
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Telephone | 408-851-3779
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Fax | 408-851-3862
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208G00000X
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Taxonomy Name | Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
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License Number | A81369
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License Number State | CA
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