Provider Demographics
NPI:1902846710
Name:MADAHAR, ASHOK KUMAR (MD)
Entity Type:Individual
Prefix:DR
First Name:ASHOK
Middle Name:KUMAR
Last Name:MADAHAR
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:PO BOX 60038
Mailing Address - Street 2:
Mailing Address - City:ARCADIA
Mailing Address - State:CA
Mailing Address - Zip Code:91066-6038
Mailing Address - Country:US
Mailing Address - Phone:626-447-0296
Mailing Address - Fax:626-447-6057
Practice Address - Street 1:5451 WALNUT AVE
Practice Address - Street 2:
Practice Address - City:CHINO
Practice Address - State:CA
Practice Address - Zip Code:91710-2609
Practice Address - Country:US
Practice Address - Phone:909-464-8666
Practice Address - Fax:909-464-8913
Is Sole Proprietor?:No
Enumeration Date:2006-06-08
Last Update Date:2008-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC42285207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00C422850Medicaid
CA00C422855Medicare PIN
CA00C422853Medicare PIN
CA00C422854Medicare PIN
CAA60698Medicare UPIN