Provider Demographics
NPI:1649406141
Name:PAIK, TOMALIKA AHSAN (MD)
Entity Type:Individual
Prefix:DR
First Name:TOMALIKA
Middle Name:AHSAN
Last Name:PAIK
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:TOMALIKA
Other - Middle Name:
Other - Last Name:AHSAN-PAIK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:3315 WATT AVE
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95821-3600
Mailing Address - Country:US
Mailing Address - Phone:916-481-6800
Mailing Address - Fax:
Practice Address - Street 1:901 CAMPUS DRIVE
Practice Address - Street 2:SUITE 102
Practice Address - City:DALY CITY
Practice Address - State:CA
Practice Address - Zip Code:94015-4930
Practice Address - Country:US
Practice Address - Phone:415-642-0707
Practice Address - Fax:650-755-8638
Is Sole Proprietor?:No
Enumeration Date:2009-06-10
Last Update Date:2015-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA116369207L00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
CACA135109Medicare PIN