Individual
JONATHAN VIVEK SUKUMAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
300 HILLMONT AVE, VENTURA, CA 93003-1651
(805) 652-6556
Mailing address
800 S VICTORIA AVE, L4615, VCHCA - PHYSICIAN SERVICES, VENTURA, CA 93009-0003
(805) 677-5181
(805) 677-5304
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
20A18429
CA
390200000X
Student in an Organized Health Care Education/Training Program
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Other
Enumeration date
04/25/2015
Last updated
07/18/2023
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