Provider Demographics
NPI:1508620220
Name:KUMAR RAVI MD FACC PC
Entity Type:Organization
Organization Name:KUMAR RAVI MD FACC PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KUMAR
Authorized Official - Middle Name:L
Authorized Official - Last Name:RAVI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:480-266-9293
Mailing Address - Street 1:4811 E PEBBLE RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:PARADISE VALLEY
Mailing Address - State:AZ
Mailing Address - Zip Code:85253-4079
Mailing Address - Country:US
Mailing Address - Phone:480-266-9293
Mailing Address - Fax:
Practice Address - Street 1:10503 W THUNDERBIRD BLVD STE 103
Practice Address - Street 2:
Practice Address - City:SUN CITY
Practice Address - State:AZ
Practice Address - Zip Code:85351-3047
Practice Address - Country:US
Practice Address - Phone:623-974-3649
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:KUMAR RAVI MD FACC PC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-02-13
Last Update Date:2024-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WC3500XNursing Service ProvidersRegistered NurseCardiac RehabilitationGroup - Multi-Specialty