Provider Demographics
NPI:1629201686
Name:KALINYAK, JUDITH E (MD, PHD)
Entity Type:Individual
Prefix:MS
First Name:JUDITH
Middle Name:E
Last Name:KALINYAK
Suffix:
Gender:F
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 BAY VIEW DR
Mailing Address - Street 2:
Mailing Address - City:SAN CARLOS
Mailing Address - State:CA
Mailing Address - Zip Code:94070-1657
Mailing Address - Country:US
Mailing Address - Phone:650-743-8478
Mailing Address - Fax:
Practice Address - Street 1:2191 MOWRY AVE
Practice Address - Street 2:SUITE 500 H
Practice Address - City:FREMONT
Practice Address - State:CA
Practice Address - Zip Code:94538-1725
Practice Address - Country:US
Practice Address - Phone:510-792-7276
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-08-25
Last Update Date:2009-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG54014207U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207U00000XAllopathic & Osteopathic PhysiciansNuclear Medicine