MEDICARE: SRINIVASA K ASHOKKUMAR M.D

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	C42227	CA

General Provider Information

NPI Number	:	1134126329
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SRINIVASA K ASHOKKUMAR M.D

Provider Business Mailing Address
First Line	:	355 ABBOTT ST STE 100
Second Line	:
City	:	SALINAS
State	:	CA
Zip	:	93901-4484
Country	:	US
Telephone Number	:	831-649-1000
Fax Number	:	831-649-4962

Provider Business Practice Location Address
First Line	:	1100 VETERANS BLVD
Second Line	:
City	:	REDWOOD CITY
State	:	CA
Zip	:	94063-2037
Country	:	US
Telephone Number	:	650-299-2015
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/01/2005
Last Update Date	:	05/26/2023

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