Provider Demographics
NPI:1225214174
Name:SANKHALA, KAMALESH K (MD)
Entity Type:Individual
Prefix:DR
First Name:KAMALESH
Middle Name:K
Last Name:SANKHALA
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 1:8950 W OLYMPIC BLVD # 565
Mailing Address - Street 2:
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90211-3561
Mailing Address - Country:US
Mailing Address - Phone:310-908-0057
Mailing Address - Fax:844-662-6772
Practice Address - Street 1:9100 WILSHIRE BLVD STE 840W
Practice Address - Street 2:
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90212-3556
Practice Address - Country:US
Practice Address - Phone:310-908-0057
Practice Address - Fax:844-662-6772
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-10
Last Update Date:2022-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA119127207RX0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX287004001Medicaid
TXTXB142336Medicare PIN