MEDICARE: ASHIM KUMAR 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	207VE0102X	Reproductive Endocrinology Physician	A80341	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	A80341	OTHER	CA	MEDICAL LISCENSE

General Provider Information

NPI Number	:	1225052459
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ASHIM KUMAR M.D.

Provider Business Mailing Address
First Line	:	16260 VENTURA BLVD
Second Line	:	SUITE 210
City	:	ENCINO
State	:	CA
Zip	:	91436-5227
Country	:	US
Telephone Number	:	818-292-2242
Fax Number	:	818-292-8914

Provider Business Practice Location Address
First Line	:	16260 VENTURA BLVD
Second Line	:	SUITE 210
City	:	ENCINO
State	:	CA
Zip	:	91436-5227
Country	:	US
Telephone Number	:	818-292-2242
Fax Number	:	818-292-8914

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

Provider Enumeration Date	:	07/27/2006
Last Update Date	:	05/11/2016

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