Provider Demographics
NPI:1144490822
Name:NIRMAL KUMAR, M.D., INC., A PROFESSIONAL CORPORATION
Entity type:Organization
Organization Name:NIRMAL KUMAR, M.D., INC., A PROFESSIONAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:NIRMAL
Authorized Official - Middle Name:
Authorized Official - Last Name:KUMAR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:626-798-8400
Mailing Address - Street 1:1350 N. ALTADENA DR.
Mailing Address - Street 2:SUITE 100
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91107-1488
Mailing Address - Country:US
Mailing Address - Phone:626-798-8400
Mailing Address - Fax:626-798-7617
Practice Address - Street 1:1350 N. ALTADENA DR.
Practice Address - Street 2:SUITE 100
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91107-1488
Practice Address - Country:US
Practice Address - Phone:626-798-8400
Practice Address - Fax:626-798-7617
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NIRMAL KUMAR, M.D., INC., A PROFESSIONAL CORPORATION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-03-10
Last Update Date:2014-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA29459207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
W22018OtherPTAN
CA00A294590Medicaid
A83956Medicare UPIN