Provider Demographics
NPI:1477750602
Name:JAIN, SUNIL KUMAR (MBBS, MD)
Entity type:Individual
Prefix:DR
First Name:SUNIL
Middle Name:KUMAR
Last Name:JAIN
Suffix:
Gender:M
Credentials:MBBS, MD
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Other - Credentials:
Mailing Address - Street 1:11234 ANDERSON ST # MC1516B
Mailing Address - Street 2:
Mailing Address - City:LOMA LINDA
Mailing Address - State:CA
Mailing Address - Zip Code:92350-1716
Mailing Address - Country:US
Mailing Address - Phone:909-558-4000
Mailing Address - Fax:909-558-0428
Practice Address - Street 1:11234 ANDERSON ST # MC1516B
Practice Address - Street 2:
Practice Address - City:LOMA LINDA
Practice Address - State:CA
Practice Address - Zip Code:92350-1716
Practice Address - Country:US
Practice Address - Phone:909-558-4000
Practice Address - Fax:909-558-0428
Is Sole Proprietor?:No
Enumeration Date:2007-06-29
Last Update Date:2024-10-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAC150187207RN0300X, 208M00000X
NC2012-00662208M00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalistGroup - Single Specialty
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrologyGroup - Single Specialty
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program