Provider Demographics
NPI:1467497891
Name:MEDICAL OFFICES OF SHASHWATI.S.KALE
Entity Type:Organization
Organization Name:MEDICAL OFFICES OF SHASHWATI.S.KALE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:SHASHWATI
Authorized Official - Middle Name:SHARAD
Authorized Official - Last Name:KALE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:408-223-8228
Mailing Address - Street 1:2690 S WHITE RD
Mailing Address - Street 2:SUITE200,
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95148-2076
Mailing Address - Country:US
Mailing Address - Phone:408-223-8228
Mailing Address - Fax:408-223-8338
Practice Address - Street 1:2690 S WHITE RD
Practice Address - Street 2:SUITE200,
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95148-2076
Practice Address - Country:US
Practice Address - Phone:408-223-8228
Practice Address - Fax:408-223-8338
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-19
Last Update Date:2008-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA067291207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAH07085Medicare UPIN