Provider Demographics
NPI:1366700411
Name:BALASINGHAM, KUMARASINGHAM (MD)
Entity type:Individual
Prefix:
First Name:KUMARASINGHAM
Middle Name:
Last Name:BALASINGHAM
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3416 DURELLO CIR
Mailing Address - Street 2:
Mailing Address - City:RANCHO CORDOVA
Mailing Address - State:CA
Mailing Address - Zip Code:95670-6913
Mailing Address - Country:US
Mailing Address - Phone:916-853-1747
Mailing Address - Fax:
Practice Address - Street 1:3416 DURELLO CIR
Practice Address - Street 2:
Practice Address - City:RANCHO CORDOVA
Practice Address - State:CA
Practice Address - Zip Code:95670-6913
Practice Address - Country:US
Practice Address - Phone:916-853-1747
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-26
Last Update Date:2012-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAFE35002174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist