MEDICARE: VIDHYA LAKSHMI KUMBERA 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	207Q00000X	Family Medicine Physician	74301	AZ

General Provider Information

NPI Number	:	1558696989
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VIDHYA LAKSHMI KUMBERA MD

Provider Business Mailing Address
First Line	:	PO BOX 33269
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85067-3269
Country	:	US
Telephone Number	:	602-406-4786
Fax Number	:	916-636-4358

Provider Business Practice Location Address
First Line	:	3477 S MERCY RD STE 201
Second Line	:
City	:	GILBERT
State	:	AZ
Zip	:	85297-0448
Country	:	US
Telephone Number	:	480-728-6580
Fax Number	:	480-728-6581

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

Provider Enumeration Date	:	10/02/2009
Last Update Date	:	02/16/2026

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