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NPI Code Detail

MEDICARE: DR. AVINASH M MONDKAR M.D.

MEDICARE: DR. AVINASH M MONDKAR M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207RC0000XCardiovascular Disease PhysicianA35142CA

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2P00736288OTHERPALMETTO GBA RAILROAD MEDICARE/NORTHERN CA
3756063687OTHERPALMETTO GBA RAILROAD MEDICARE/SOUTHERN CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1316956899
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. AVINASH M MONDKAR M.D.
Provider Business Mailing Address
First Line : 2080 CENTURY PARK E STE 704
Second Line :
City : LOS ANGELES
State : CA
Zip : 90067-2010
Country : US
Telephone Number : 310-657-1995
Fax Number : 866-431-8496
Provider Business Practice Location Address
First Line : 2080 CENTURY PARK E STE 704
Second Line :
City : LOS ANGELES
State : CA
Zip : 90067-2010
Country : US
Telephone Number : 310-657-1995
Fax Number : 866-431-8496
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/05/2006
Last Update Date : 08/20/2019

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