Provider Demographics
NPI:1629308515
Name:TANK, NIKI HIMAT (MD)
Entity Type:Individual
Prefix:DR
First Name:NIKI
Middle Name:HIMAT
Last Name:TANK
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:NIKI
Other - Middle Name:DIPESH
Other - Last Name:PATEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:625 SOUTH FAIR OAKS AVE
Mailing Address - Street 2:SUITE 345
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91105
Mailing Address - Country:US
Mailing Address - Phone:424-314-0203
Mailing Address - Fax:424-314-0205
Practice Address - Street 1:625 SOUTH FAIR OAKS AVE
Practice Address - Street 2:SUITE 345
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91105
Practice Address - Country:US
Practice Address - Phone:424-314-0203
Practice Address - Fax:424-314-0205
Is Sole Proprietor?:Yes
Enumeration Date:2009-12-28
Last Update Date:2024-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA114900207R00000X, 207RX0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine