MEDICARE: PIYUSH (PHIL) KUMAR, MD, INC

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	174400000X	Specialist	A44592	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	ZZZ07412Z	OTHER	CA	PROVIDER NUMBER

General Provider Information

NPI Number	:	1659339687
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PIYUSH (PHIL) KUMAR, MD, INC

Provider Business Mailing Address
First Line	:	700 GARDEN VIEW CT
Second Line	:	SUITE 102
City	:	ENCINITAS
State	:	CA
Zip	:	92024-2464
Country	:	US
Telephone Number	:	760-436-8881
Fax Number	:	760-436-1022

Provider Business Practice Location Address
First Line	:	700 GARDEN VIEW CT
Second Line	:	SUITE 102
City	:	ENCINITAS
State	:	CA
Zip	:	92024-2464
Country	:	US
Telephone Number	:	760-436-8881
Fax Number	:	760-436-1022

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. PIYUSH KUMAR
Credential	:	MD
Telephone Number	:	760-436-8881

Provider Enumeration Date	:	05/01/2006
Last Update Date	:	08/22/2020

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