Basic Information
| Provider Information | |||||||||
| NPI: | 1164042016 | ||||||||
| EntityType: | 1 | ||||||||
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| LastName: | KUMAR | ||||||||
| FirstName: | SUNIL | ||||||||
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| Mailing Information | |||||||||
| Address1: | PARKVIEW MEDICAL CENTER GRADUATE MEDICAL EDUCATION | ||||||||
| Address2: | OFFICE WEST 400 16TH STREET | ||||||||
| City: | PUEBLO | ||||||||
| State: | CO | ||||||||
| PostalCode: | 81003 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7195957585 | ||||||||
| FaxNumber: | 7195957589 | ||||||||
| Practice Location | |||||||||
| Address1: | PARKVIEW ADULT MEDICINE CLINIC | ||||||||
| Address2: | 311 WEST 14TH STREET | ||||||||
| City: | PUEBLO | ||||||||
| State: | CO | ||||||||
| PostalCode: | 81003 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7195957585 | ||||||||
| FaxNumber: | 7195857589 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/21/2020 | ||||||||
| LastUpdateDate: | 04/21/2020 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 04/21/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 390200000X | TL0008353 | CO | Y | Student, Health Care | Student in an Organized Health Care Education/Training Program |
No ID Information.