Provider Demographics
NPI:1467750901
Name:KAIN KUMAR MD INC
Entity Type:Organization
Organization Name:KAIN KUMAR MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KAIN
Authorized Official - Middle Name:
Authorized Official - Last Name:KUMAR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:661-947-5600
Mailing Address - Street 1:1415 W ROSAMOND BLVD
Mailing Address - Street 2:SUITE 24
Mailing Address - City:ROSAMOND
Mailing Address - State:CA
Mailing Address - Zip Code:93560-7429
Mailing Address - Country:US
Mailing Address - Phone:661-947-5600
Mailing Address - Fax:661-947-5900
Practice Address - Street 1:1415 W ROSAMOND BLVD
Practice Address - Street 2:SUITE 24
Practice Address - City:ROSAMOND
Practice Address - State:CA
Practice Address - Zip Code:93560-7429
Practice Address - Country:US
Practice Address - Phone:661-947-5600
Practice Address - Fax:661-947-5900
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-08
Last Update Date:2011-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA67882207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA67882OtherLIC NUMBER
CAA67882OtherLIC NUMBER
CA1265431316Medicare PIN