DR. AMOD TENDULKAR (NPI# 1457511628) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1457511628 |
| Entity Type | Individual |
| Full Name | DR. AMOD TENDULKAR |
| Credential | MD |
| Practice Address |
1617 N California St Suite 1d Stockton CA 95204-6117 |
| Practice Telephone | 2099481234 |
| Mailing Telephone | 2099481234 |
| Enumeration Date | 2008-06-11 |
| Last Update Date | 2010-07-11 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208G00000X | Thoracic Surgery (Cardiothoracic Vascular Surgery) | A81369 | CA | Allopathic & Osteopathic Physicians |
| Street Address |
1617 N CALIFORNIA ST SUITE 1D |
| City | STOCKTON |
| State | CA |
| Zip Code | 95204-6117 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437158706 | Shermilla Shunmugham | Obstetrics & Gynecology | 1617 N California St, Ste 2b, Stockton, CA 95204-6117 | 2005-07-19 |
| 1821534686 | Valley Perinatal & Genetics Diagnostic Center Medical Group, Inc. | Obstetrics & Gynecology | 1617 N California St, Ste. 2d, Stockton, CA 95204-6117 | 2017-01-17 |
| 1982064754 | Mehdi Akhavan-heidari Md Inc | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 1617 N California St, Suite 1d, Stockton, CA 95204-6117 | 2016-03-07 |
| 1659635134 | David Julius Russell | Obstetrics & Gynecology | 1617 N California St, Ste. 2f, Stockton, CA 95204-6117 | 2012-06-28 |
| 1154684892 | Anubhi Rishikesh Kulkarni | Obstetrics & Gynecology | 1617 N California St, Ste 2a, Stockton, CA 95204 | 2012-06-18 |
| 1457643330 | Chikanele Egondu Okorie | Specialist | 1617 N California St, Ste. 2a, Stockton, CA 95204-6117 | 2011-05-10 |
| 1871883199 | Kayla Mapps | Obstetrics & Gynecology | 1617 N California St, Ste. 2a, Stockton, CA 95204-6117 | 2011-04-08 |
| 1487968541 | Rishikesh Pradip Kulkarni | Obstetrics & Gynecology | 1617 N California St, Ste 2a, Stockton, CA 95204-6117 | 2010-08-01 |
| 1861704645 | Eugenia Hurlbut | Specialist | 1617 N California St, Ste. 2a, Stockton, CA 95204-6117 | 2010-07-08 |
| 1437460516 | Amod P Tendulkar Md Inc | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 1617 N California St, Suite 1d, Stockton, CA 95204-6117 | 2010-06-23 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962027524 | Kariem Abdelwahed | Licensed Vocational Nurse | 1630 N. Edison St Stockton Ca, Stockton, CA 95204 | 2020-06-10 |
| 1831730555 | Ronnie C Murray | Counselor | 1947 North California Street, Stockton, CA 95204 | 2019-10-03 |
| 1235614116 | Michelle Ann Horn | Marriage & Family Therapist | 3666 Mission Rd, Stockton, CA 95204 | 2018-09-26 |
| 1356830947 | Stockton Pace | PACE Provider Organization | 582 E. Harding Way, Stockton, CA 95204 | 2018-05-09 |
| 1790228781 | Rebecca Phongsa | Counselor | 1947 North Calfornia Street, Suite B, Stockton, CA 95204 | 2016-11-23 |
| 1700332905 | Serim Kang | Driver | 4222 N Pershing Ave, Suite D2, Stockton, CA 95204 | 2016-08-28 |
| 1033565544 | Philip John Brereton | Orthotist | 466 E Harding Way, Stockton, CA 95204 | 2016-05-13 |
| 1932507522 | David Grayson | Counselor | 1621 Brookside Rd, Stockton, CA 95204 | 2014-12-12 |
| 1174934897 | Gurtej Malhi | Internal Medicine | 1901 N California Street, Stockton, CA 95204 | 2014-05-15 |
| 1396156170 | Rajesh Saini | Nurse Practitioner | 1805 N California St. Suite 102, Stockton, CA 95204 | 2014-05-14 |
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| Taxonomy Code | 208G00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Thoracic Surgery (Cardiothoracic Vascular Surgery) |
| A thoracic surgeon provides the operative, perioperative and critical care of patients with pathologic conditions within the chest. Included is the surgical care of coronary artery disease, cancers of the lung, esophagus and chest wall, abnormalities of the trachea, abnormalities of the great vessels and heart valves, congenital anomalies, tumors of the mediastinum and diseases of the diaphragm. The management of the airway and injuries of the chest is within the scope of the specialty. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Thoracic Surgery, 2007. http://www.abts.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Thoracic Surgery. Thoracic surgeons have the knowledge, experience and technical skills to accurately diagnose, operate upon safely, and effectively manage patients with thoracic diseases of the chest. This requires substantial knowledge of cardiorespiratory physiology and oncology, as well as capability in the use of heart assist devices, management of abnormal heart rhythms and drainage of the chest cavity, respiratory support systems, endoscopy and invasive and noninvasive diagnostic techniques. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033223060 | James Dell Morrissey | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 1617 N California St Suite 1d, Stockton, CA 95204 | 2006-08-18 |
| 1982064754 | Mehdi Akhavan-heidari Md Inc | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 1617 N California St, Suite 1d, Stockton, CA 95204-6117 | 2016-03-07 |
| 1437460516 | Amod P Tendulkar Md Inc | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 1617 N California St, Suite 1d, Stockton, CA 95204-6117 | 2010-06-23 |
| 1184945180 | Isam Felahy M D Inc | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 2800 N California St, Suite 15, Stockton, CA 95204-3757 | 2010-06-14 |
| 1851424410 | Jerome M. Mcdonald, M.d. Inc. | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 1617 N California St, Suite 1d, Stockton, CA 95204-6117 | 2007-03-13 |
| 1316059306 | Isam Felahy | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 2800 N California St, Suite 15, Stockton, CA 95204-3757 | 2006-08-31 |
| 1144261173 | John B Overton | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 420 W Acacia St, Suite 17, Stockton, CA 95203-2441 | 2006-06-09 |
| 1104897362 | Timothy J Sloan Md, A Professional Corporation | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 1800 N California St, Stockton, CA 95204 | 2006-01-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598370728 | North County Cvt Surgery Associates | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 3156 Vista Way Ste 100, Oceanside, CA 92056-3694 | 2020-09-14 |
| 1417560756 | Valiana Vascular Institute Inc. | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 2501 E Chapman Ave Ste 220, Fullerton, CA 92831-3108 | 2020-08-26 |
| 1891252474 | Miguel Puig Md A Medical Corporation | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 1430 Esplanade Ste 10, Chico, CA 95926-3366 | 2019-03-01 |
| 1598247991 | Pavel V Petrik Medical Corporation | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 1331 W Avenue J Ste 203, Lancaster, CA 93534-2954 | 2018-08-31 |
| 1942797378 | Sharon A Bogerty Md Inc | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 105 N Bascom Ave Ste 101b, San Jose, CA 95128-1811 | 2018-04-20 |
| 1992231112 | Samer Kanaan Md A Professional Corporation | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 27451 Los Altos, Suite 290, Mission Viejo, CA 92691 | 2017-05-08 |
| 1073065512 | Central California Chest Surgery | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 729 N Medical Center Dr W Ste 223, Clovis, CA 93611-6885 | 2016-11-01 |
| 1407214612 | George Arnold Mulder | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 1150 Laurel St, Pasadena, CA 91103-2329 | 2016-02-02 |
| 1760849905 | Steven R Gundry Md Medical Corporation | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 555 E Tachevah Dr Ste 3w103, Palm Springs, CA 92262-5747 | 2016-01-19 |
| 1386018687 | Riyad Youssef Tarazi | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 9120 Judicial Dr, Apt 7522, San Diego, CA 92122-6700 | 2015-11-24 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.