Provider Demographics
NPI:1942239306
Name:KUMAR, DINESH (MD)
Entity Type:Individual
Prefix:DR
First Name:DINESH
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:PO BOX 50966
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92619-0966
Mailing Address - Country:US
Mailing Address - Phone:714-617-5163
Mailing Address - Fax:714-617-5786
Practice Address - Street 1:1101 BRYAN AVE STE E
Practice Address - Street 2:
Practice Address - City:TUSTIN
Practice Address - State:CA
Practice Address - Zip Code:92780-4401
Practice Address - Country:US
Practice Address - Phone:714-617-5163
Practice Address - Fax:714-617-5786
Is Sole Proprietor?:No
Enumeration Date:2006-06-30
Last Update Date:2021-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA84090207RI0011X, 207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1092541Medicaid
H93661Medicare UPIN
LA4K075CP07Medicare PIN
LA1092541Medicaid
EP968ZMedicare PIN