Provider Demographics
NPI:1114080314
Name:MOHANKUMAR, H T (MD)
Entity Type:Individual
Prefix:MR
First Name:H
Middle Name:T
Last Name:MOHANKUMAR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6001 TRUXTUN AVE
Mailing Address - Street 2:SUITE #160
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93309-0679
Mailing Address - Country:US
Mailing Address - Phone:661-323-6410
Mailing Address - Fax:661-323-0634
Practice Address - Street 1:4000 W METROPOLITAN DR STE 120
Practice Address - Street 2:
Practice Address - City:ORANGE
Practice Address - State:CA
Practice Address - Zip Code:92868-3504
Practice Address - Country:US
Practice Address - Phone:661-444-1567
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-18
Last Update Date:2022-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA416772084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
00A445840Medicare ID - Type Unspecified
CAE25143Medicare UPIN