Provider Demographics
NPI:1285824409
Name:KUMAR, RASHA (OPTOMETRIST OD)
Entity Type:Individual
Prefix:MR
First Name:RASHA
Middle Name:
Last Name:KUMAR
Suffix:
Gender:M
Credentials:OPTOMETRIST OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12148 NORTH 134TH WAY
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85259
Mailing Address - Country:US
Mailing Address - Phone:480-657-0015
Mailing Address - Fax:480-657-0019
Practice Address - Street 1:1695 NORTH ARIZONA BOULEVARD
Practice Address - Street 2:
Practice Address - City:COOLIDGE
Practice Address - State:AZ
Practice Address - Zip Code:85228
Practice Address - Country:US
Practice Address - Phone:520-723-8641
Practice Address - Fax:520-723-8643
Is Sole Proprietor?:No
Enumeration Date:2007-07-25
Last Update Date:2007-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ687152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
U25004Medicare UPIN