Healthcare Provider Details
I. General information
NPI: 1881962637
Provider Name (Legal Business Name): KAIN KUMAR, M.D., INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 12/08/2011
Last Update Date: 12/08/2011
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
540 W PALMDALE BLVD SUITE B
PALMDALE CA
93551-4232
US
IV. Provider business mailing address
2980 N BEVERLY GLEN CIR SUITE 301
LOS ANGELES CA
90077-1726
US
V. Phone/Fax
- Phone: 661-947-5600
- Fax:
- Phone: 310-474-9809
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 332900000X |
| Taxonomy | Non-Pharmacy Dispensing Site |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
KAIN
KUMAR
Title or Position: OWNER
Credential: M.D.
Phone: 661-947-5600