Provider Demographics
NPI:1861855694
Name:HEMAL, KSHITIJ (MD)
Entity Type:Individual
Prefix:
First Name:KSHITIJ
Middle Name:
Last Name:HEMAL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:SIJ
Other - Middle Name:
Other - Last Name:HEMAL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 31309
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90031-0309
Mailing Address - Country:US
Mailing Address - Phone:323-276-3707
Mailing Address - Fax:
Practice Address - Street 1:1516 SAN PABLO ST FL 5
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90033-5313
Practice Address - Country:US
Practice Address - Phone:323-276-3707
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-03-30
Last Update Date:2022-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA177355208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology