Provider Demographics
NPI:1205948288
Name:KUMAR, SANJAY (MD)
Entity type:Individual
Prefix:
First Name:SANJAY
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 1:2400 BATH ST
Mailing Address - Street 2:SUITE 201
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93105-4351
Mailing Address - Country:US
Mailing Address - Phone:805-682-7707
Mailing Address - Fax:805-682-7710
Practice Address - Street 1:2400 BATH ST
Practice Address - Street 2:SUITE 201
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93105-4351
Practice Address - Country:US
Practice Address - Phone:805-682-7707
Practice Address - Fax:805-682-7710
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2012-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA51189207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A511890Medicaid
CA00A511890Medicaid
CAG19556Medicare UPIN