Provider Demographics
NPI:1760721310
Name:KHEMKA AND KHEMKA M.D., INC.
Entity Type:Organization
Organization Name:KHEMKA AND KHEMKA M.D., INC.
Other - Org Name:UNITED CARDIOLOGY A MEDICAL GROUP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JUDTH
Authorized Official - Middle Name:
Authorized Official - Last Name:BAHENA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:714-956-7231
Mailing Address - Street 1:1211 W LA PALMA AVE
Mailing Address - Street 2:SUITE 410
Mailing Address - City:ANAHEIM
Mailing Address - State:CA
Mailing Address - Zip Code:92801-2863
Mailing Address - Country:US
Mailing Address - Phone:714-956-7231
Mailing Address - Fax:714-758-9676
Practice Address - Street 1:1211 W LA PALMA AVE
Practice Address - Street 2:SUITE 410
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92801-2863
Practice Address - Country:US
Practice Address - Phone:714-956-7231
Practice Address - Fax:714-758-9676
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-02-01
Last Update Date:2013-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA25263207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty