Provider Demographics
NPI:1366946170
Name:KAMBOJ, GEORGIA NIKI (MBBS, PHD)
Entity type:Individual
Prefix:DR
First Name:GEORGIA
Middle Name:NIKI
Last Name:KAMBOJ
Suffix:
Gender:F
Credentials:MBBS, PHD
Other - Prefix:DR
Other - First Name:GEORGIA
Other - Middle Name:N
Other - Last Name:KAIDONIS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MBBS
Mailing Address - Street 1:1445 BUSH ST
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94109-5520
Mailing Address - Country:US
Mailing Address - Phone:415-972-4600
Mailing Address - Fax:415-975-0999
Practice Address - Street 1:1445 BUSH ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94109-5520
Practice Address - Country:US
Practice Address - Phone:415-972-4600
Practice Address - Fax:415-975-0999
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-19
Last Update Date:2022-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA175031207WX0107X, 207WX0108X
390200000X
CAA168668207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
No207WX0107XAllopathic & Osteopathic PhysiciansOphthalmologyRetina Specialist
No207WX0108XAllopathic & Osteopathic PhysiciansOphthalmologyUveitis and Ocular Inflammatory Disease
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program