Provider Demographics
NPI:1851414866
Name:KUHAR, IGOR
Entity Type:Individual
Prefix:MR
First Name:IGOR
Middle Name:
Last Name:KUHAR
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18016 VENTURA BLVD 1/2
Mailing Address - Street 2:
Mailing Address - City:ENCINO
Mailing Address - State:CA
Mailing Address - Zip Code:91316-3530
Mailing Address - Country:US
Mailing Address - Phone:818-705-0840
Mailing Address - Fax:818-705-4507
Practice Address - Street 1:18016 VENTURA BLVD 1/2
Practice Address - Street 2:
Practice Address - City:ENCINO
Practice Address - State:CA
Practice Address - Zip Code:91316-3516
Practice Address - Country:US
Practice Address - Phone:818-705-0840
Practice Address - Fax:818-705-4507
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-06
Last Update Date:2008-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA357314-86332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADME 02313FMedicaid
CADME 02313FMedicaid