Provider Demographics
NPI:1265431316
Name:KUMAR, KAIN (MD, PHD)
Entity type:Individual
Prefix:DR
First Name:KAIN
Middle Name:
Last Name:KUMAR
Suffix:
Gender:M
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:540 W PALMDALE BLVD
Mailing Address - Street 2:B
Mailing Address - City:PALMDALE
Mailing Address - State:CA
Mailing Address - Zip Code:93551-4232
Mailing Address - Country:US
Mailing Address - Phone:661-947-5600
Mailing Address - Fax:661-947-5900
Practice Address - Street 1:540 W PALMDALE BLVD
Practice Address - Street 2:B
Practice Address - City:PALMDALE
Practice Address - State:CA
Practice Address - Zip Code:93551-4232
Practice Address - Country:US
Practice Address - Phone:661-947-5600
Practice Address - Fax:661-947-5900
Is Sole Proprietor?:No
Enumeration Date:2005-07-20
Last Update Date:2011-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA67882207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A678820Medicaid
CA00A678821Medicaid
CA00A678821Medicaid
CAA67882Medicare ID - Type Unspecified
CA00A678820Medicare ID - Type Unspecified