| Kusum M Ohri, Md Inc. | |
|
1310 W. Stewart Dr. Suite 602 Orange CA 92868-3857 | |
| (714) 639-0414 | |
| (714) 639-3313 |
| Full Name | Kusum M Ohri, Md Inc. |
|---|---|
| Speciality | Internal Medicine |
| Location | 1310 W. Stewart Dr., Orange, California |
| Authorized Official Name and Position | Kusum M Ohri (PRESIDENT) |
| Authorized Official Contact | 7146390414 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Kusum M Ohri, Md Inc. 1310 W Stewart Dr Suite 602 Orange CA 92868-3857 Ph: (714) 639-0414 | Kusum M Ohri, Md Inc. 1310 W. Stewart Dr. Suite 602 Orange CA 92868-3857 Ph: (714) 639-0414 |
| NPI Number | 1629037213 |
|---|---|
| Provider Enumeration Date | 03/21/2006 |
| Last Update Date | 07/15/2022 |
| Medicare PECOS PAC ID | 4981794476 |
|---|---|
| Medicare Enrollment ID | O20071220000571 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1629037213 | NPI | - | NPPES |
| ZZZ56075Y | Other | CA | BLUE SHIELD OF CALIFORNIA |
| 00A442180 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | A 44218 (California) | Secondary |
| 207R00000X | Internal Medicine | A44218 (California) | Primary |
| Provider Name | Kusum M Ohri |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1477692333 PECOS PAC ID: 0446340939 Enrollment ID: I20071220000569 |
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