1578578365 NPI number — DR. KANAGARATNAM SIVALINGAM M.D.

Table of content: DR. KANAGARATNAM SIVALINGAM M.D. (NPI 1578578365)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1578578365 NPI number — DR. KANAGARATNAM SIVALINGAM M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SIVALINGAM
Provider First Name:
KANAGARATNAM
Provider Middle Name:
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
M

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:
1578578365
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
12/18/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
44725 N. 10TH ST WEST
Provider Second Line Business Mailing Address:
SUITE 170
Provider Business Mailing Address City Name:
LANCASTER
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
93534
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
661-726-3724
Provider Business Mailing Address Fax Number:
661-726-3723

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
44725 N. 10TH ST. WEST
Provider Second Line Business Practice Location Address:
SUITE 170
Provider Business Practice Location Address City Name:
LANCASTER
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
93534
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
661-726-3724
Provider Business Practice Location Address Fax Number:
661-726-3063
Provider Enumeration Date:
07/30/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207RG0300X , with the licence number:  A30091 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 174400000X , with the licence number: A30091 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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





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