Greater Valley Physicians Medical Group Inc

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

License

A49715 Issued in CA

Legal business name

GREATER VALLEY PHYSICIANS MEDICAL GROUP INC

Practice address

2219 S Hacienda Blvd
Suite 101
Hacienda Heights, CA 91745-4639

Phone

(626) 961-2461

Fax

(626) 330-5392

NPI assigned

Oct 16, 2007

Last updated

Mar 8, 2013By 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

Lakshman Makandura, MDNPI 1578614657

Title

Physician/ Owner

Phone

(626) 961-2461

Specialties & licenses 1

Addresses

Other identifiers 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 6

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.

• Lakshman D Makandura, M.D

  • Internal Medicine Physician
  • West Covina, CA
  • NPI 1578614657
  NPD (past) Authorized official
• Michael John Pancho Bunag, NP

  • Nurse Practitioner
  • West Covina, CA
  • NPI 1104414101
  NPD (past)
• Gayana Chuklansev, FNP

  • Family Nurse Practitioner
  • West Covina, CA
  • NPI 1467063214
  NPD (past)
• Sandra M Kochaon, PA-C

  • Medical Physician Assistant
  • West Covina, CA
  • NPI 1336470871
  NPD (past)
• Devesh N Patel, MD

  • Infectious Disease Physician
  • West Covina, CA
  • NPI 1407840697

  Single Specialty

  NPD (past)
• Oliver C Tsai, M.D.

  • Geriatric Medicine (Internal Medicine) Physician
  • West Covina, CA
  • NPI 1306828272
  NPD (past)

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

{
    "created_epoch": "1192492800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1362700800000",
    "number": "1053500991",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2219 S HACIENDA BLVD",
            "address_2": "SUITE 101",
            "city": "HACIENDA HEIGHTS",
            "state": "CA",
            "postal_code": "917454639",
            "telephone_number": "626-961-2461",
            "fax_number": "626-330-5392"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2219 S HACIENDA BLVD",
            "address_2": "SUITE 101",
            "city": "HACIENDA HEIGHTS",
            "state": "CA",
            "postal_code": "917454639",
            "telephone_number": "626-961-2461",
            "fax_number": "626-330-5392"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREATER VALLEY PHYSICIANS MEDICAL GROUP INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-16",
        "last_updated": "2013-03-08",
        "status": "A",
        "authorized_official_last_name": "MAKANDURA",
        "authorized_official_first_name": "LAKSHMAN",
        "authorized_official_title_or_position": "PHYSICIAN/ OWNER",
        "authorized_official_telephone_number": "626-961-2461",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "CA",
            "license": "A49715",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A49715",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jordan Gonzalez
• Michel Gonzalez
• Roberto Antonio Gonzalez
• Susana Gonzalez, M.S, LMFT
• Good Consulting Corporation (Health & Beauty Academy)
• Diana Carolina Grimaud, ACSW
• GSM Healthcare Service, LLC (Walbrook House)
• GSM Healthcare Service,LLC (Helen Evans Home)
• Jane S Gu, MD
• Ron Y Gu, MD

• Primary Care Clinic/Center in Hacienda Heights, CA
• Providers in Hacienda Heights, CA by specialty
• Primary Care Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.