Healthcare Provider Details

I. General information

NPI: 1225052459
Provider Name (Legal Business Name): ASHIM KUMAR M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/27/2006
Last Update Date: 05/11/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16260 VENTURA BLVD SUITE 210
ENCINO CA
91436-5227
US

IV. Provider business mailing address

16260 VENTURA BLVD SUITE 210
ENCINO CA
91436-5227
US

V. Phone/Fax

Practice location:
  • Phone: 818-292-2242
  • Fax: 818-292-8914
Mailing address:
  • Phone: 818-292-2242
  • Fax: 818-292-8914

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VE0102X
TaxonomyReproductive Endocrinology Physician
License NumberA80341
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: