Provider Demographics
NPI:1821859661
Name:KANDU MEDICAL SERVICES WEST PC
Entity Type:Organization
Organization Name:KANDU MEDICAL SERVICES WEST PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT, MEDICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:NANCEY
Authorized Official - Middle Name:TREVANIAN
Authorized Official - Last Name:TSAI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:833-526-3848
Mailing Address - Street 1:210 E HACIENDA AVE
Mailing Address - Street 2:
Mailing Address - City:CAMPBELL
Mailing Address - State:CA
Mailing Address - Zip Code:95008-6617
Mailing Address - Country:US
Mailing Address - Phone:833-526-3848
Mailing Address - Fax:
Practice Address - Street 1:210 E HACIENDA AVE
Practice Address - Street 2:
Practice Address - City:CAMPBELL
Practice Address - State:CA
Practice Address - Zip Code:95008-6617
Practice Address - Country:US
Practice Address - Phone:833-526-3848
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-18
Last Update Date:2024-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty
No103G00000XBehavioral Health & Social Service ProvidersClinical NeuropsychologistGroup - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No152W00000XEye and Vision Services ProvidersOptometristGroup - Multi-Specialty
No208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Multi-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty