Provider Demographics
NPI:1689014755
Name:ANKOLEKAR, SHEETAL (MD)
Entity Type:Individual
Prefix:
First Name:SHEETAL
Middle Name:
Last Name:ANKOLEKAR
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:SHEETAL
Other - Middle Name:
Other - Last Name:ANKOLEKAR
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:625 LINCOLN AVE
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95126-3785
Mailing Address - Country:US
Mailing Address - Phone:408-871-5260
Mailing Address - Fax:408-871-3237
Practice Address - Street 1:625 LINCOLN AVE
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95126-3785
Practice Address - Country:US
Practice Address - Phone:408-871-5260
Practice Address - Fax:408-871-3237
Is Sole Proprietor?:No
Enumeration Date:2013-07-03
Last Update Date:2020-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA125643207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAHL117ZMedicare PIN