Provider Demographics
NPI:1518963032
Name:KUMAR, ASHOK (MD)
Entity Type:Individual
Prefix:DR
First Name:ASHOK
Middle Name:
Last Name: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 1:4477 W 118TH ST
Mailing Address - Street 2:STE 200
Mailing Address - City:HAWTHORNE
Mailing Address - State:CA
Mailing Address - Zip Code:90250-2257
Mailing Address - Country:US
Mailing Address - Phone:310-675-4440
Mailing Address - Fax:310-675-2970
Practice Address - Street 1:ACE MEDICAL GROUP, 4477 W 118TH ST
Practice Address - Street 2:STE 200
Practice Address - City:HAWTHORNE
Practice Address - State:CA
Practice Address - Zip Code:90250-2257
Practice Address - Country:US
Practice Address - Phone:310-675-4440
Practice Address - Fax:310-675-2970
Is Sole Proprietor?:No
Enumeration Date:2005-06-21
Last Update Date:2010-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA38582207R00000X, 207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA85146Medicare UPIN