Basic Information
Provider Information
NPI: 1003826660
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: SAMANT
FirstName: SADHANA
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1411 E 31ST ST
Address2: OAKCARE MEDICAL GROUP
City: OAKLAND
State: CA
PostalCode: 946021018
CountryCode: US
TelephoneNumber: 5104374323
FaxNumber: 5104375042
Practice Location
Address1: 1411 E 31ST ST
Address2: OAKCARE MEDICAL GROUP
City: OAKLAND
State: CA
PostalCode: 946021018
CountryCode: US
TelephoneNumber: 5104374323
FaxNumber: 5104375042
Other Information
ProviderEnumerationDate: 08/08/2006
LastUpdateDate: 12/22/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207V00000XA48492CAY Allopathic & Osteopathic PhysiciansObstetrics & Gynecology 

ID Information
IDTypeStateIssuerDescription
00A48492005CA MEDICAID


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