Provider Demographics
NPI:1134126329
Name:ASHOKKUMAR, SRINIVASA K (MD)
Entity Type:Individual
Prefix:
First Name:SRINIVASA
Middle Name:K
Last Name:ASHOKKUMAR
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 1:355 ABBOTT ST STE 100
Mailing Address - Street 2:
Mailing Address - City:SALINAS
Mailing Address - State:CA
Mailing Address - Zip Code:93901-4484
Mailing Address - Country:US
Mailing Address - Phone:831-649-1000
Mailing Address - Fax:831-649-4962
Practice Address - Street 1:1100 VETERANS BLVD
Practice Address - Street 2:
Practice Address - City:REDWOOD CITY
Practice Address - State:CA
Practice Address - Zip Code:94063-2037
Practice Address - Country:US
Practice Address - Phone:650-299-2015
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-07-01
Last Update Date:2023-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC42227207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA37766Medicare UPIN