Individual provider Active NPI

Konidala D Naidu, MD

  • Internal Medicine Physician
  • Laguna Hills, CA
National Provider Identifier
1265512180
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A32687 Issued in CA
Practice address
24411 Health Center Dr
Ste 630
Laguna Hills, CA 92653-3651
Phone
(949) 770-7907
NPI assigned
Oct 16, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X A32687 CA Primary

Addresses

Primary practice location

24411 Health Center Dr
Ste 630
Laguna Hills, CA 92653-3651

Mailing address

24411 Health Center Dr
Ste 630
Laguna Hills, CA 92653-3651
Phone (949) 770-7907

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

NPI Registry JSON

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

{
    "created_epoch": "1160956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1265512180",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24411 HEALTH CENTER DR",
            "address_2": "STE 630",
            "city": "LAGUNA HILLS",
            "state": "CA",
            "postal_code": "926533651",
            "telephone_number": "949-770-7907"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24411 HEALTH CENTER DR",
            "address_2": "STE 630",
            "city": "LAGUNA HILLS",
            "state": "CA",
            "postal_code": "926533651",
            "telephone_number": "949-770-7907"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NAIDU",
        "first_name": "KONIDALA",
        "middle_name": "D",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-16",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A32687",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Laguna Hills, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.