Virender Jit Kamboj, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

A36755 Issued in CA

Practice address

2522 Grand Canal Blvd
Stockton, CA 95207-8213

Phone

(209) 952-1434

Fax

(209) 952-5059

NPI assigned

Jan 4, 2007

Last updated

Sep 17, 2010By the provider in NPPES

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 4

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1167868800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1284681600000",
    "number": "1548317167",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4728 LONGCOVE DR",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952191749",
            "telephone_number": "209-477-7046"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2522 GRAND CANAL BLVD",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952078213",
            "telephone_number": "209-952-1434",
            "fax_number": "209-952-5059"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAMBOJ",
        "first_name": "VIRENDER",
        "middle_name": "JIT",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-04",
        "last_updated": "2010-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A36755",
            "primary": false
        },
        {
            "code": "207QA0505X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Adult Medicine",
            "state": "CA",
            "license": "A36755",
            "primary": false
        },
        {
            "code": "207QG0300X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": "CA",
            "license": "A36755",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A36755",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CA STATE MEDICAL LIS.",
            "identifier": "A36755",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A367550",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Muhtada Abdulelah Kamal Aldin
• Aziz Kamali, M.D.
• Ibrahim Bobson Kamara
• Mustapha Kamara
• Kory Kambara
• Hesham Kamel, MD
• Masanobu Kamigaki, MD
• Adrianna Kaitlyn Kamplain-Bridges
• Rhonda Kamps
• Kanathan LLC (3N medstaff)

• Internal Medicine Physician in Stockton, CA
• Providers in Stockton, CA by specialty
• Internal Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.