Provider Demographics
NPI:1184718215
Name:KAMAL, BINDU M (MD)
Entity type:Individual
Prefix:
First Name:BINDU
Middle Name:M
Last Name:KAMAL
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:PO BOX 1206
Mailing Address - Street 2:
Mailing Address - City:GOLETA
Mailing Address - State:CA
Mailing Address - Zip Code:93116-1206
Mailing Address - Country:US
Mailing Address - Phone:805-682-5879
Mailing Address - Fax:805-563-4629
Practice Address - Street 1:1704 STATE STREET
Practice Address - Street 2:
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93101
Practice Address - Country:US
Practice Address - Phone:805-682-5879
Practice Address - Fax:805-563-4629
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-03
Last Update Date:2015-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA68308207R00000X, 207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A683080Medicaid
CAA68308OtherMEDICAL LICENSE
H76985Medicare UPIN