Provider Demographics
NPI:1659339687
Name:PIYUSH (PHIL) KUMAR, MD, INC
Entity Type:Organization
Organization Name:PIYUSH (PHIL) KUMAR, MD, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:PIYUSH
Authorized Official - Middle Name:
Authorized Official - Last Name:KUMAR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:760-436-8881
Mailing Address - Street 1:700 GARDEN VIEW CT
Mailing Address - Street 2:SUITE 102
Mailing Address - City:ENCINITAS
Mailing Address - State:CA
Mailing Address - Zip Code:92024-2464
Mailing Address - Country:US
Mailing Address - Phone:760-436-8881
Mailing Address - Fax:760-436-1022
Practice Address - Street 1:700 GARDEN VIEW CT
Practice Address - Street 2:SUITE 102
Practice Address - City:ENCINITAS
Practice Address - State:CA
Practice Address - Zip Code:92024-2464
Practice Address - Country:US
Practice Address - Phone:760-436-8881
Practice Address - Fax:760-436-1022
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA44592174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAW15473Medicaid
CA00A445921Medicaid
CAZZZ07412ZOtherPROVIDER NUMBER
CA00A445921Medicaid