Provider Demographics
NPI:1194789875
Name:KUMAR, RAVIN R (MD)
Entity type:Individual
Prefix:
First Name:RAVIN
Middle Name:R
Last Name:KUMAR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:21840 NORMANDIE AVE
Mailing Address - Street 2:STE. 700
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90502-2047
Mailing Address - Country:US
Mailing Address - Phone:310-222-5189
Mailing Address - Fax:310-782-6786
Practice Address - Street 1:21840 NORMANDIE AVE
Practice Address - Street 2:STE. 700
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90502-2047
Practice Address - Country:US
Practice Address - Phone:310-222-5189
Practice Address - Fax:310-782-6786
Is Sole Proprietor?:No
Enumeration Date:2006-04-12
Last Update Date:2010-03-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA65950208C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208C00000XAllopathic & Osteopathic PhysiciansColon & Rectal Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A659500Medicaid
CAWA65950AMedicare PIN
CAWA65950CMedicare PIN
CAA65950Medicare PIN
CAWA65950BMedicare PIN
CA00A659500Medicaid