Basic Information
| Provider Information | |||||||||
| NPI: | 1194987263 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | PROMOD KUMAR | ||||||||
| FirstName: | RAMACHANDRAN PILLAI | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 25455 BARTON RD SUITE A 108 | ||||||||
| Address2: | |||||||||
| City: | LOMA LINDA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 92354 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9095586388 | ||||||||
| FaxNumber: | 9095586309 | ||||||||
| Practice Location | |||||||||
| Address1: | 25455 BARTON RD STE 108A | ||||||||
| Address2: | |||||||||
| City: | LOMA LINDA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 923543139 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9095586388 | ||||||||
| FaxNumber: | 9095584825 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/30/2008 | ||||||||
| LastUpdateDate: | 10/16/2017 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207T00000X | 57.014461 | OH | N | Allopathic & Osteopathic Physicians | Neurological Surgery | 207T00000X | A137836 | CA | Y | Allopathic & Osteopathic Physicians | Neurological Surgery |
No ID Information.