Provider Demographics
NPI:1114952488
Name:KANDAVEL, MONICA P (MD)
Entity Type:Individual
Prefix:
First Name:MONICA
Middle Name:P
Last Name:KANDAVEL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18370 BURBANK BLVD
Mailing Address - Street 2:SUITE 307
Mailing Address - City:TARZANA
Mailing Address - State:CA
Mailing Address - Zip Code:91356-2804
Mailing Address - Country:US
Mailing Address - Phone:818-996-6000
Mailing Address - Fax:818-996-4712
Practice Address - Street 1:18370 BURBANK BLVD
Practice Address - Street 2:SUITE 307
Practice Address - City:TARZANA
Practice Address - State:CA
Practice Address - Zip Code:91356-2804
Practice Address - Country:US
Practice Address - Phone:818-996-6000
Practice Address - Fax:818-996-4712
Is Sole Proprietor?:No
Enumeration Date:2006-07-12
Last Update Date:2021-12-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA84903208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics