Provider Demographics
NPI:1225046097
Name:KUMAR, SANGEETA LALL (MD)
Entity Type:Individual
Prefix:MRS
First Name:SANGEETA
Middle Name:LALL
Last Name:KUMAR
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:SANGEETA
Other - Middle Name:
Other - Last Name:LALL
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:18762 PIMLICO TER
Mailing Address - Street 2:
Mailing Address - City:YORBA LINDA
Mailing Address - State:CA
Mailing Address - Zip Code:92886-7016
Mailing Address - Country:US
Mailing Address - Phone:714-779-7893
Mailing Address - Fax:
Practice Address - Street 1:18762 PIMLICO TER
Practice Address - Street 2:
Practice Address - City:YORBA LINDA
Practice Address - State:CA
Practice Address - Zip Code:92886-7016
Practice Address - Country:US
Practice Address - Phone:714-779-7893
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-04
Last Update Date:2021-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC52079207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAH67284Medicare UPIN