Healthcare Provider Details

I. General information

NPI: 1144490822
Provider Name (Legal Business Name): NIRMAL KUMAR, M.D., INC., A PROFESSIONAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/10/2008
Last Update Date: 11/17/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1350 N. ALTADENA DR. SUITE 100
PASADENA CA
91107-1488
US

IV. Provider business mailing address

1350 N. ALTADENA DR. SUITE 100
PASADENA CA
91107-1488
US

V. Phone/Fax

Practice location:
  • Phone: 626-798-8400
  • Fax: 626-798-7617
Mailing address:
  • Phone: 626-798-8400
  • Fax: 626-798-7617

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License NumberA29459
License Number StateCA

VIII. Authorized Official

Name: DR. NIRMAL KUMAR
Title or Position: PRESIDENT
Credential: M.D.
Phone: 626-798-8400