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General NPI Number Information
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NPI Number | 1962724187
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Entity Type | Organization
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Legal Business Name | VASANTH K KUMAR M D INC
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Dates
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Enumeration Date | 02/16/2010
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Last Update Date | 09/26/2018
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Provider Practice Location Address
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Address Line | 5245 VISTA LEJANA LN
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City | LA CANADA
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State | CA
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Zip | 91011-1860
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Country | US
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Telephone | 213-595-6383
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Fax |
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Provider Business Mailing Address
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Address Line | 5245 VISTA LEJANA LN
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City | LA CANADA
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State | CA
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Zip | 91011-1860
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Country | US
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Telephone | 213-595-6383
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | VASANTH KUKKALA KUMAR
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Credential | M D
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Telephone | 213-595-6383
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RH0003X
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Taxonomy Name | Hematology & Oncology Physician
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License Number | A32885
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License Number State | CA
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