Provider Demographics
NPI:1568470888
Name:KUMAR, RAMANA V (MD)
Entity Type:Individual
Prefix:
First Name:RAMANA
Middle Name:V
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 1:8727 ARCADIA AVENUE
Mailing Address - Street 2:
Mailing Address - City:SAN GABRIEL
Mailing Address - State:CA
Mailing Address - Zip Code:91775-1201
Mailing Address - Country:US
Mailing Address - Phone:818-557-0135
Mailing Address - Fax:818-557-1394
Practice Address - Street 1:1401 GARCES HIGHWAY
Practice Address - Street 2:
Practice Address - City:DELANO
Practice Address - State:CA
Practice Address - Zip Code:93215-3690
Practice Address - Country:US
Practice Address - Phone:661-721-5262
Practice Address - Fax:661-721-5254
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-03
Last Update Date:2011-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA67763207P00000X
IL036-097539207R00000X, 207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A677630Medicaid
IL036097539-2Medicaid
IL3932056OtherBLUE SHIELD
KY7100151850Medicaid
IL214881053Medicare PIN
CA00A677635Medicare PIN
IL036097539-2Medicaid
CAH07058Medicare UPIN
CA00A677630Medicaid