Provider Demographics
NPI:1114303302
Name:SIKAVI, CAMERON SOLAMAN (MD)
Entity Type:Individual
Prefix:DR
First Name:CAMERON
Middle Name:SOLAMAN
Last Name:SIKAVI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8631 W 3RD ST STE 1015E
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90048-5913
Mailing Address - Country:US
Mailing Address - Phone:310-652-4472
Mailing Address - Fax:855-898-4055
Practice Address - Street 1:3440 LOMITA BLVD STE 320
Practice Address - Street 2:
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90505-4824
Practice Address - Country:US
Practice Address - Phone:310-534-8200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-08-11
Last Update Date:2022-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA147450207RG0100X, 207RG0100X
IL036.146653207R00000X
IL036146653208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036.146653OtherILLINOIS STATE LICENSE