Provider Demographics
NPI:1750999140
Name:KAMLESH K SANKHALA MD INC
Entity type:Organization
Organization Name:KAMLESH K SANKHALA MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:KAMALESH
Authorized Official - Middle Name:K
Authorized Official - Last Name:SANKHALA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:310-908-0057
Mailing Address - Street 1:1171 S ROBERTSON BLVD # 145
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90035-1403
Mailing Address - Country:US
Mailing Address - Phone:310-908-0057
Mailing Address - Fax:310-908-0057
Practice Address - Street 1:9100 WILSHIRE BLVD STE 840W
Practice Address - Street 2:
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90212-3556
Practice Address - Country:US
Practice Address - Phone:310-908-0057
Practice Address - Fax:844-662-6772
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-21
Last Update Date:2024-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & OncologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA119127Medicaid