Provider Demographics
NPI:1114654449
Name:DOC PK INC
Entity Type:Organization
Organization Name:DOC PK INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:PARDEEP
Authorized Official - Middle Name:
Authorized Official - Last Name:KAHLON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:408-475-5590
Mailing Address - Street 1:4700 NORTHGATE BLVD STE 100
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95834-1149
Mailing Address - Country:US
Mailing Address - Phone:916-929-6161
Mailing Address - Fax:
Practice Address - Street 1:4700 NORTHGATE BLVD STE 100
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95834-1149
Practice Address - Country:US
Practice Address - Phone:916-929-6161
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-05
Last Update Date:2022-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care
No251E00000XAgenciesHome Health
No251G00000XAgenciesHospice Care, Community Based
No261QC1500XAmbulatory Health Care FacilitiesClinic/CenterCommunity Health
No261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
No261QP2400XAmbulatory Health Care FacilitiesClinic/CenterPrison Health
No261QX0100XAmbulatory Health Care FacilitiesClinic/CenterOccupational Medicine