Individual
DR. SURINDER KUMAR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D., FACP,FASN,CCD
Contact information
Practice address
1595 SOQUEL DR., SUITE 210, SANTA CRUZ, CA 95065-1719
(831) 476-1551
(831) 476-3241
Mailing address
1595 SOQUEL DR., SUITE 210, SANTA CRUZ, CA 95065-1719
(831) 476-1551
(831) 476-3421
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
A320240
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A320240
—
CA
01
—
942809523
OLD TAX ID #
CA
01
—
P00237353
MEDICARE RR
CA
01
—
ZZZ66323Z
BLUE SHIELD PROV. ID
CA
Enumeration date
09/29/2006
Last updated
11/03/2009
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