Healthcare Provider Details

I. General information

NPI: 1811144504
Provider Name (Legal Business Name): BINAY KUMAR M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: FNU BINAYKUMAR

II. Dates (important events)

Enumeration Date: 08/25/2008
Last Update Date: 07/31/2024
Certification Date: 07/31/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2110 PROFESSIONAL DR STE 120
ROSEVILLE CA
95661-3779
US

IV. Provider business mailing address

3400 DATA DR
RANCHO CORDOVA CA
95670-7956
US

V. Phone/Fax

Practice location:
  • Phone: 916-536-2500
  • Fax: 916-780-3904
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number4301092043
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberMD0456103
License Number StatePA
# 3
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberC152906
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: