Provider Demographics
NPI:1235543638
Name:HARISH KUMAR, CHINTAN (MD)
Entity Type:Individual
Prefix:
First Name:CHINTAN
Middle Name:
Last Name:HARISH KUMAR
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 1:1222 OLD CARRIAGE LN SE
Mailing Address - Street 2:
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35802-2783
Mailing Address - Country:US
Mailing Address - Phone:720-515-3494
Mailing Address - Fax:
Practice Address - Street 1:11180 WARNER AVE STE 353
Practice Address - Street 2:
Practice Address - City:FOUNTAIN VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92708-7516
Practice Address - Country:US
Practice Address - Phone:714-968-6789
Practice Address - Fax:714-202-2626
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-13
Last Update Date:2023-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA168947207Q00000X, 2083X0100X, 207Q00000X
ALMD.39305207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
No2083X0100XAllopathic & Osteopathic PhysiciansPreventive MedicineOccupational Medicine