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General NPI Number Information
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NPI Number | 1245143288
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Entity Type | Organization
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Legal Business Name | LEGACY PRIME INSURANCE SERVICES LLC
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Dates
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Enumeration Date | 09/22/2026
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Last Update Date | 09/22/2026
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Provider Practice Location Address
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Address Line | 237 RESERVE CT
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City | SAN MARCOS
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State | CA
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Zip | 92078-2054
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Country | US
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Telephone | 914-904-6841
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Fax | 877-777-0450
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Provider Business Mailing Address
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Address Line | 237 RESERVE CT
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City | SAN MARCOS
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State | CA
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Zip | 92078-2054
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Country | US
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Telephone | 914-904-6841
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Fax | 877-777-0450
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Authorized Official
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Title or Position | CEO
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Name | MR. VIKALP KUMAR
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Credential |
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Telephone | 914-904-6841
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2081P2900X
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Taxonomy Name | Pain Medicine (Physical Medicine & Rehabilitation) Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 208VP0000X
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Taxonomy Name | Pain Medicine Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 332BD1200X
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Taxonomy Name | Dialysis Equipment & Supplies (DME)
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License Number |
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License Number State |
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