Provider Demographics
NPI:1578998589
Name:KAMDAR, ELIKA (PA-C, MMS)
Entity Type:Individual
Prefix:MRS
First Name:ELIKA
Middle Name:
Last Name:KAMDAR
Suffix:
Gender:F
Credentials:PA-C, MMS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11525 BROOKSHIRE AVE
Mailing Address - Street 2:STE 101
Mailing Address - City:DOWNEY
Mailing Address - State:CA
Mailing Address - Zip Code:90241-4982
Mailing Address - Country:US
Mailing Address - Phone:949-297-3838
Mailing Address - Fax:
Practice Address - Street 1:35 CREEK RD
Practice Address - Street 2:
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92604-4724
Practice Address - Country:US
Practice Address - Phone:949-297-3838
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-09
Last Update Date:2016-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPA23201363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant