Provider Demographics
NPI:1578652111
Name:KUMAR, NIRMAL (MD)
Entity Type:Individual
Prefix:DR
First Name:NIRMAL
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 1:1350 N. ALTADENA DR.
Mailing Address - Street 2:SUITE 100
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91107-1488
Mailing Address - Country:US
Mailing Address - Phone:626-798-8400
Mailing Address - Fax:626-798-7617
Practice Address - Street 1:1350 N. ALTADENA DR.
Practice Address - Street 2:SUITE 100
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91107-1488
Practice Address - Country:US
Practice Address - Phone:626-798-8400
Practice Address - Fax:626-798-7617
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-12
Last Update Date:2008-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA29459207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A294590Medicaid
WA29459BOtherPTAN
WA29459BOtherPTAN