Basic Information
| Provider Information | |||||||||
| NPI: | 1720234024 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | KUMAR | ||||||||
| FirstName: | PIYUSH | ||||||||
| MiddleName: | |||||||||
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| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
| OtherOrganizationName: | |||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 3067 | ||||||||
| Address2: | |||||||||
| City: | YUBA CITY | ||||||||
| State: | CA | ||||||||
| PostalCode: | 959923067 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5307514784 | ||||||||
| FaxNumber: | 5307514906 | ||||||||
| Practice Location | |||||||||
| Address1: | 726 4TH ST | ||||||||
| Address2: | |||||||||
| City: | MARYSVILLE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 959015656 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5307494697 | ||||||||
| FaxNumber: | 5307494688 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/18/2008 | ||||||||
| LastUpdateDate: | 11/19/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
| IsOrganizationSubpart: | |||||||||
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| NPICertificationDate: | 11/19/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | A131556 | CA | N | Allopathic & Osteopathic Physicians | Family Medicine | 208M00000X | A131556 | CA | Y | Allopathic & Osteopathic Physicians | Hospitalist |
ID Information
| ID | Type | State | Issuer | Description | 1720234024 | 05 | CA | MEDICAID |