Provider Demographics
NPI:1295730497
Name:MANIKTALA, KALPANA (MD)
Entity type:Individual
Prefix:
First Name:KALPANA
Middle Name:
Last Name:MANIKTALA
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 1:4419 VAN NUYS BLVD
Mailing Address - Street 2:STE 206
Mailing Address - City:SHERMAN OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91403-5713
Mailing Address - Country:US
Mailing Address - Phone:818-995-1041
Mailing Address - Fax:818-995-6308
Practice Address - Street 1:4419 VAN NUYS BLVD
Practice Address - Street 2:STE 206
Practice Address - City:SHERMAN OAKS
Practice Address - State:CA
Practice Address - Zip Code:91403-5713
Practice Address - Country:US
Practice Address - Phone:818-995-1041
Practice Address - Fax:818-995-6308
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-06-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA371652084P0800X, 2084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Not Answered2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry