Provider Demographics
NPI:1790033280
Name:KAMAKSHI R ZEIDLER MD PC
Entity Type:Organization
Organization Name:KAMAKSHI R ZEIDLER MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROVIDER/ OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KAMAKSHI
Authorized Official - Middle Name:R
Authorized Official - Last Name:ZEIDLER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:408-356-4959
Mailing Address - Street 1:3803 S BASCOM AVE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:CAMPBELL
Mailing Address - State:CA
Mailing Address - Zip Code:95008-7317
Mailing Address - Country:US
Mailing Address - Phone:408-356-4959
Mailing Address - Fax:408-358-8692
Practice Address - Street 1:3803 S BASCOM AVE
Practice Address - Street 2:SUITE 100
Practice Address - City:CAMPBELL
Practice Address - State:CA
Practice Address - Zip Code:95008-7317
Practice Address - Country:US
Practice Address - Phone:408-356-4959
Practice Address - Fax:408-358-8692
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-08-15
Last Update Date:2012-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic SurgeryGroup - Single Specialty