1144490822 NPI number — NIRMAL KUMAR, M.D., INC., A PROFESSIONAL CORPORATION

Table of content: (NPI 1144490822)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1144490822 NPI number — NIRMAL KUMAR, M.D., INC., A PROFESSIONAL CORPORATION

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
NIRMAL KUMAR, M.D., INC., A PROFESSIONAL CORPORATION
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1144490822
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/17/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1350 N. ALTADENA DR.
Provider Second Line Business Mailing Address:
SUITE 100
Provider Business Mailing Address City Name:
PASADENA
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
91107-1488
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
626-798-8400
Provider Business Mailing Address Fax Number:
626-798-7617

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1350 N. ALTADENA DR.
Provider Second Line Business Practice Location Address:
SUITE 100
Provider Business Practice Location Address City Name:
PASADENA
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
91107-1488
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
626-798-8400
Provider Business Practice Location Address Fax Number:
626-798-7617
Provider Enumeration Date:
03/10/2008

Additional Information

Authorized Official

Authorized Official Last Name:
KUMAR
Authorized Official First Name:
NIRMAL
Authorized Official Middle Name:
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
626-798-8400

Provider Taxonomy Codes

  • Taxonomy code: 207RN0300X , with the licence number:  A29459 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: W22018 . This is a "PTAN" identifier . This identifiers is of the category "OTHER".
  • Identifier: 00A294590 , issued by the state of ( CA ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2024 www.npivalidator.com