Healthcare Provider Details

I. General information

NPI: 1720102197
Provider Name (Legal Business Name): ANJULI KUMAR M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/19/2007
Last Update Date: 04/23/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1760 TERMINO AVE STE 300
LONG BEACH CA
90804-2157
US

IV. Provider business mailing address

1760 TERMINO AVE STE 300
LONG BEACH CA
90804-2157
US

V. Phone/Fax

Practice location:
  • Phone: 562-933-3009
  • Fax: 562-933-8557
Mailing address:
  • Phone: 562-933-3009
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberA93207
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: