Provider Demographics
NPI:1174263941
Name:KUMAR, DUSHYANT
Entity Type:Individual
Prefix:
First Name:DUSHYANT
Middle Name:
Last Name:KUMAR
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1517 PEPPERTREE DR
Mailing Address - Street 2:
Mailing Address - City:LA HABRA HEIGHTS
Mailing Address - State:CA
Mailing Address - Zip Code:90631-8534
Mailing Address - Country:US
Mailing Address - Phone:562-640-0949
Mailing Address - Fax:
Practice Address - Street 1:1517 PEPPERTREE DR
Practice Address - Street 2:
Practice Address - City:LA HABRA HEIGHTS
Practice Address - State:CA
Practice Address - Zip Code:90631-8534
Practice Address - Country:US
Practice Address - Phone:562-640-0949
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-30
Last Update Date:2022-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program