Provider Demographics
NPI:1942575998
Name:MITHAL, ALKA (MD)
Entity Type:Individual
Prefix:DR
First Name:ALKA
Middle Name:
Last Name:MITHAL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:175 ELEANOR DR
Mailing Address - Street 2:
Mailing Address - City:WOODSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:94062-1113
Mailing Address - Country:US
Mailing Address - Phone:650-780-0200
Mailing Address - Fax:
Practice Address - Street 1:114 5TH AVE
Practice Address - Street 2:
Practice Address - City:REDWOOD CITY
Practice Address - State:CA
Practice Address - Zip Code:94063-3604
Practice Address - Country:US
Practice Address - Phone:650-839-1447
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-03-08
Last Update Date:2012-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA051594207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine