Kishore K Vasant Medical Group Inc.

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

License

A33638 Issued in CA

Legal business name

KISHORE K VASANT MEDICAL GROUP INC.

Practice address

36450 Inland Valley Dr
Suite # 116
Wildomar, CA 92595-9583

Phone

(951) 698-8876

Fax

(951) 698-5560

NPI assigned

Jun 23, 2006

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Kishore K Vasant, M.D.NPI 1790711661

Title

Ceo

Phone

(951) 698-8876

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Kishore K Vasant I, M.D.

  • Allergy & Immunology Physician
  • Murrieta, CA
  • NPI 1790711661
  Authorized official Same address or phone

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1151020800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1518993484",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "36450 INLAND VALLEY DR",
            "address_2": "SUITE # 116",
            "city": "WILDOMAR",
            "state": "CA",
            "postal_code": "925959583",
            "telephone_number": "951-698-8876",
            "fax_number": "951-698-5560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "36450 INLAND VALLEY DR",
            "address_2": "SUITE # 116",
            "city": "WILDOMAR",
            "state": "CA",
            "postal_code": "925959583",
            "telephone_number": "951-698-8876",
            "fax_number": "951-698-5560"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KISHORE K VASANT MEDICAL GROUP INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-23",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "VASANT",
        "authorized_official_first_name": "KISHORE",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "951-698-8876",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "CA",
            "license": "A33638",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A336380",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Phillisha Kimbles
• Kimjem Management Inc
• Kinder Care Home Health Inc
• Deja Kinder
• Naomi Kiratu
• Lorena Klear, BCBA,BA,M.A.
• Sierra Koch
• Karen Lynn Koskinen
• Zeljka Helena Kostich, M.D
• Hamed Koushyar, DDS

• Clinic/Center in Wildomar, CA
• Providers in Wildomar, CA by specialty
• Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.