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NPI Code Detail

MEDICARE: DEEPA LAKSHMI KUMMATI M.D.

MEDICARE: DEEPA LAKSHMI KUMMATI 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
1207R00000XInternal Medicine PhysicianC153084CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1750566154
Entity Type Code : Individual
Provider Name (Legal Business Name) : DEEPA LAKSHMI KUMMATI M.D.
Provider Business Mailing Address
First Line : 4900 CALIFORNIA AVE STE 400B
Second Line :
City : BAKERSFIELD
State : CA
Zip : 93309-7081
Country : US
Telephone Number : 217-361-7374
Fax Number :
Provider Business Practice Location Address
First Line : 4900 CALIFORNIA AVE STE 400B
Second Line :
City : BAKERSFIELD
State : CA
Zip : 93309-7081
Country : US
Telephone Number : 217-361-7374
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/03/2008
Last Update Date : 11/13/2018

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