Basic Information
Provider Information
NPI: 1184931693
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: JUDGE
FirstName: ONKAR
MiddleName:  
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 500 W HOSPITAL RD
Address2:  
City: FRENCH CAMP
State: CA
PostalCode: 952319693
CountryCode: US
TelephoneNumber: 2094686937
FaxNumber: 9167347980
Practice Location
Address1: 500 W HOSPITAL RD
Address2:  
City: FRENCH CAMP
State: CA
PostalCode: 952319693
CountryCode: US
TelephoneNumber: 2094686937
FaxNumber: 2094687042
Other Information
ProviderEnumerationDate: 09/03/2010
LastUpdateDate: 12/20/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207L00000XA114755CAY Allopathic & Osteopathic PhysiciansAnesthesiology 

No ID Information.


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