Kudtarkar, Sanjay

Kudtarkar, Sanjay is an individual health care provider with primary practice located at 1998 N Arrowhead Ave , San Bernardino CA 92405-4116. He recently has only one registered license in Other Service Providers / Specialist, which is considered as his primary health care specialty. Kudtarkar, Sanjay can be contacted via phone (909) 882-0988.

Contact Information

Primary practice address
1998 N Arrowhead Ave San Bernardino CA 92405-4116
Phone: (909) 882-0988
Fax: (909) 886-1301
Website:
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Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X A64957 California

Profile Details

NPI number 1477634632
LBN Legal business name Kudtarkar, Sanjay
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 17th, 2006
Last updated Mar 7th, 2023 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1477634632 NPPES
California MEDICAID 00A649570

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