Provider Demographics
NPI:1164981023
Name:TAMHANE, JAEE SHRIKANT (DO)
Entity type:Individual
Prefix:MISS
First Name:JAEE
Middle Name:SHRIKANT
Last Name:TAMHANE
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1465 BENEDICT CANYON DR
Mailing Address - Street 2:
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90210-2021
Mailing Address - Country:US
Mailing Address - Phone:310-344-0346
Mailing Address - Fax:
Practice Address - Street 1:1141 WEST RENDONDO BEACH BLVD
Practice Address - Street 2:STE 306
Practice Address - City:GARDENA
Practice Address - State:CA
Practice Address - Zip Code:90247
Practice Address - Country:US
Practice Address - Phone:310-344-0346
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-19
Last Update Date:2024-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A20494207P00000X
NYUNKNOWN207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine