Individual
SUMIT KOHLI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
34 MARK WEST SPRINGS RD FL 2, SANTA ROSA, CA 95403-1766
(707) 541-7900
(707) 573-5411
Mailing address
325 DISTEL CIR, LOS ALTOS, CA 94022-1408
(707) 541-7900
(707) 573-5411
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
016073
ME
207RG0100X
Gastroenterology Physician
649059
CA
207RG0100X
Gastroenterology Physician
A758490
CA
207RT0003X
Transplant Hepatology Physician
Primary
A75849
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
060459
ATHEM
—
01
—
3182394
AETNA
—
01
—
A75849
STATE MEDICAL LICENSE
CA
01
—
P000083083
RAILROAD MEDICARE
—
Enumeration date
12/01/2005
Last updated
11/16/2020
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