MEDICARE: DR. SANJAY KUMAR MD

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	207X00000X	Orthopaedic Surgery Physician	A104866	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	ME93542	OTHER	FL	MEDICAL LICENSE
2	A104866	OTHER	CA	MEDICAL LICENSE

General Provider Information

NPI Number	:	1518948108
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SANJAY KUMAR MD

Provider Business Mailing Address
First Line	:	7300 N FRESNO ST
Second Line	:
City	:	FRESNO
State	:	CA
Zip	:	93720-2941
Country	:	US
Telephone Number	:	559-448-4580
Fax Number	:	559-448-4075

Provider Business Practice Location Address
First Line	:	7300 N FRESNO ST
Second Line	:
City	:	FRESNO
State	:	CA
Zip	:	93720-2941
Country	:	US
Telephone Number	:	559-448-4580
Fax Number	:	559-448-4075

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

Provider Enumeration Date	:	11/10/2005
Last Update Date	:	12/14/2021

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