Healthcare Provider Details

I. General information

NPI: 1811024805
Provider Name (Legal Business Name): VIJAY KUMAR MD MEDICAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/27/2007
Last Update Date: 05/27/2026
Certification Date: 05/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1174 AMAZON WAY
SIMI VALLEY CA
93065-3156
US

IV. Provider business mailing address

1174 AMAZON WAY
SIMI VALLEY CA
93065-3156
US

V. Phone/Fax

Practice location:
  • Phone: 805-527-5878
  • Fax: 805-527-0114
Mailing address:
  • Phone: 805-527-5878
  • Fax: 805-527-0114

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License NumberA46673
License Number StateCA

VIII. Authorized Official

Name: VIJAY KUMAR
Title or Position: OWNER
Credential:
Phone: 805-527-5878