Provider Demographics
NPI:1386301703
Name:SIKANDRA TANK, MD, PC
Entity type:Organization
Organization Name:SIKANDRA TANK, MD, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SIKANDRA
Authorized Official - Middle Name:
Authorized Official - Last Name:TANK
Authorized Official - Suffix:
Authorized Official - Credentials:MD, MPH
Authorized Official - Phone:559-499-1233
Mailing Address - Street 1:138 N BRAND BLVD
Mailing Address - Street 2:SUITE 200, UNIT 240
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91203
Mailing Address - Country:US
Mailing Address - Phone:559-499-1233
Mailing Address - Fax:713-562-6818
Practice Address - Street 1:138 N BRAND BLVD
Practice Address - Street 2:SUITE 200, UNIT 240
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91203
Practice Address - Country:US
Practice Address - Phone:559-499-1233
Practice Address - Fax:713-564-6818
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-11-19
Last Update Date:2021-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RH0002XAllopathic & Osteopathic PhysiciansInternal MedicineHospice and Palliative MedicineGroup - Single Specialty