MEDICARE: KUMAR S. RAJA, M.D INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RS0012X	Sleep Medicine (Internal Medicine) Physician	A26451	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1538373584
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KUMAR S. RAJA, M.D INC

Provider Business Mailing Address
First Line	:	3562 VENTURE DR
Second Line	:
City	:	HUNTINGTON BEACH
State	:	CA
Zip	:	92649-7101
Country	:	US
Telephone Number	:	714-875-9466
Fax Number	:	714-847-6864

Provider Business Practice Location Address
First Line	:	3562 VENTURE DR
Second Line	:
City	:	HUNTINGTON BEACH
State	:	CA
Zip	:	92649-2536
Country	:	US
Telephone Number	:	714-875-9466
Fax Number	:	714-847-6864

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. KUMAR SWAMY RAJA
Credential	:	M.D
Telephone Number	:	714-875-9466

Provider Enumeration Date	:	05/09/2007
Last Update Date	:	07/30/2014

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