Provider Demographics
NPI:1972536654
Name:KARMAKAR, KANKA (MD)
Entity type:Individual
Prefix:DR
First Name:KANKA
Middle Name:
Last Name:KARMAKAR
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 1:1428 HIGHLAND AVE
Mailing Address - Street 2:
Mailing Address - City:NATIONAL CITY
Mailing Address - State:CA
Mailing Address - Zip Code:91950-4624
Mailing Address - Country:US
Mailing Address - Phone:844-200-2426
Mailing Address - Fax:
Practice Address - Street 1:2060 W 24TH ST
Practice Address - Street 2:
Practice Address - City:YUMA
Practice Address - State:AZ
Practice Address - Zip Code:85364-6123
Practice Address - Country:US
Practice Address - Phone:928-344-5112
Practice Address - Fax:928-344-5766
Is Sole Proprietor?:No
Enumeration Date:2006-07-08
Last Update Date:2018-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ30919208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
1962507376OtherCLINIC NPI
1043324932OtherCLINIC NPI
AZ759194Medicaid
1245344316OtherCLINIC NPI
1063433720OtherCLINIC NPI
AZ759194Medicaid
031805Medicare Oscar/Certification
031806Medicare Oscar/Certification
AZZ21114Medicare PIN
1245344316OtherCLINIC NPI
1063433720OtherCLINIC NPI
031824Medicare Oscar/Certification
031823Medicare Oscar/Certification
AZZ21130Medicare PIN
1962507376OtherCLINIC NPI
Z21116Medicare PIN