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Individual

MANISHA S. KUMAR

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
D.O.

Contact information

Practice address
3811 VALLEY CENTRE DR, SAN DIEGO, CA 92130-3318
(858) 764-3465
Mailing address
54433 FILE, LOS ANGELES, CA 90074-0001

Taxonomy

Speciality
Code
Description
License number
State
207RR0500X
Rheumatology Physician
Primary
20A7919
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00AX79190
CA
01
020A79190
BLUE SHIELD OF CA
01
A081
CHAMPUS
01
B078
CHAMPUS
Enumeration date
09/01/2006
Last updated
06/26/2009
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