Individual
SANT KUMAR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
3621 GLENCREST DR, MODESTO, CA 95355-8431
(209) 575-4575
(209) 575-4598
Mailing address
PO BOX 4978, MODESTO, CA 95352-4978
(209) 575-4575
(209) 575-4598
Taxonomy
Speciality
Code
Description
License number
State
374700000X
Technician
Primary
RHF20122
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
XRO599710
—
CA
01
—
ZZZ21690Z
MEDICARE
CA
Enumeration date
01/15/2019
Last updated
12/09/2019
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