Provider Demographics
NPI:1457511628
Name:TENDULKAR, AMOD (MD)
Entity Type:Individual
Prefix:DR
First Name:AMOD
Middle Name:
Last Name:TENDULKAR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:710 LAWRENCE EXPY DEPT 342
Mailing Address - Street 2:
Mailing Address - City:SANTA CLARA
Mailing Address - State:CA
Mailing Address - Zip Code:95051-5173
Mailing Address - Country:US
Mailing Address - Phone:408-851-3779
Mailing Address - Fax:408-851-3862
Practice Address - Street 1:710 LAWRENCE EXPY DEPT 342
Practice Address - Street 2:
Practice Address - City:SANTA CLARA
Practice Address - State:CA
Practice Address - Zip Code:95051-5173
Practice Address - Country:US
Practice Address - Phone:408-851-3779
Practice Address - Fax:408-851-3862
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-11
Last Update Date:2022-02-04
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA81369208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)