Basic Information
| Provider Information | |||||||||
| NPI: | 1548403173 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | RAVICHANDRAN KUMAR | ||||||||
| FirstName: | PREETHI | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | D.O. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1498 PACIFIC AVE | ||||||||
| Address2: | SUITE 400 | ||||||||
| City: | TACOMA | ||||||||
| State: | WA | ||||||||
| PostalCode: | 984024208 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8445465287 | ||||||||
| FaxNumber: | 8883702434 | ||||||||
| Practice Location | |||||||||
| Address1: | 8280 W WARM SPRINGS RD | ||||||||
| Address2: | |||||||||
| City: | LAS VEGAS | ||||||||
| State: | NV | ||||||||
| PostalCode: | 891133612 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7024928000 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 04/13/2009 | ||||||||
| LastUpdateDate: | 10/19/2016 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 1548403173 | MA | Y | Allopathic & Osteopathic Physicians | Internal Medicine | 208M00000X | DO1776 | NV | N | Allopathic & Osteopathic Physicians | Hospitalist |
No ID Information.