Healthcare Provider Details

I. General information

NPI: 1124525621
Provider Name (Legal Business Name): KUNAL RAGHUBANS SINHA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/11/2018
Last Update Date: 02/20/2025
Certification Date: 02/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

520 SUPERIOR AVE STE 300
NEWPORT BEACH CA
92663-3668
US

IV. Provider business mailing address

520 SUPERIOR AVE STE 300
NEWPORT BEACH CA
92663-3668
US

V. Phone/Fax

Practice location:
  • Phone: 949-764-1411
  • Fax:
Mailing address:
  • Phone: 949-764-1411
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208VP0014X
TaxonomyInterventional Pain Medicine Physician
License NumberA164292
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License NumberA164292
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: