Basic Information
| Provider Information | |||||||||
| NPI: | 1568738375 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | KUMAR | ||||||||
| FirstName: | PRIYANKA | ||||||||
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| Credential: | PT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3244 SEPULVEDA BLVD | ||||||||
| Address2: | |||||||||
| City: | TORRANCE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 905052719 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3105398800 | ||||||||
| FaxNumber: | 3106985410 | ||||||||
| Practice Location | |||||||||
| Address1: | 100 UCLA MEDICAL PLZ | ||||||||
| Address2: | #400 | ||||||||
| City: | LOS ANGELES | ||||||||
| State: | CA | ||||||||
| PostalCode: | 900246970 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3105398800 | ||||||||
| FaxNumber: | 3104430444 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/26/2012 | ||||||||
| LastUpdateDate: | 03/26/2012 | ||||||||
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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 | 225100000X | 38630 | CA | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.