Healthcare Provider Details

I. General information

NPI: 1295049575
Provider Name (Legal Business Name): KUMAR SANAM M.B.B.S.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/29/2010
Last Update Date: 08/14/2026
Certification Date: 08/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

275 W HERNDON AVE
CLOVIS CA
93612-0204
US

IV. Provider business mailing address

275 W HERNDON AVE
CLOVIS CA
93612-0204
US

V. Phone/Fax

Practice location:
  • Phone: 559-203-3600
  • Fax: 559-910-9955
Mailing address:
  • Phone: 559-203-3600
  • Fax: 559-910-9955

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberA181797
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License NumberA181797
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: