Provider Demographics
NPI:1306852363
Name:SINHA, KUSUM (MD)
Entity Type:Individual
Prefix:DR
First Name:KUSUM
Middle Name:
Last Name:SINHA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10790 RANCHO BERNARDO RD
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92127-5705
Mailing Address - Country:US
Mailing Address - Phone:760-806-5400
Mailing Address - Fax:
Practice Address - Street 1:130 CEDAR RD # 100
Practice Address - Street 2:
Practice Address - City:VISTA
Practice Address - State:CA
Practice Address - Zip Code:92083-5102
Practice Address - Country:US
Practice Address - Phone:760-806-5400
Practice Address - Fax:760-631-3274
Is Sole Proprietor?:No
Enumeration Date:2006-07-31
Last Update Date:2020-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA46034207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A460340Medicaid
CAF02742Medicare UPIN
CAWA46034IMedicare ID - Type Unspecified