Organization Active NPI

Lakshman D Makandura MD Inc

  • Internal Medicine Physician
  • West Covina, CA
National Provider Identifier
1316242639
Registry record updated Jan 18, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A49715 Issued in CA
Legal business name
LAKSHMAN D MAKANDURA MD INC
Practice address
910 S Sunset Ave
Suite 8
West Covina, CA 91790-3409
Phone
(626) 338-8407
Fax
(626) 338-3937
NPI assigned
Jan 18, 2011
Last updated
Jan 18, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 18, 2011

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

Authorized official

Name
Dr. Lakshman D Makandura, MDNPI 1578614657
Title
President
Phone
(626) 338-8407

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X A49715 CA Primary

Addresses

Primary practice location

910 S Sunset Ave
Suite 8
West Covina, CA 91790-3409

Mailing address

910 S Sunset Ave
Suite 8
West Covina, CA 91790-3409
Phone (626) 338-8407

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120822000212 CA Part B Supplier - Clinic/Group Practice 8426205774 Receives reassigned benefits from 1 practitioner
Practice locations: Perris, CA; West Covina, CA

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
05D0916507Lakshman D Makandura MD Inc910 South Sunset #8, West Covina, CA 91790Certificate of waiverJun 23, 2028

National Provider Directory

National Provider Directory

Locations

910 S Sunset Ave
Ste 8
West Covina, CA 91790
Phone (626) 338-8407

Practitioners & affiliated clinicians

Practitioners 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1295308800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1295308800000",
    "number": "1316242639",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "910 S SUNSET AVE",
            "address_2": "SUITE 8",
            "city": "WEST COVINA",
            "state": "CA",
            "postal_code": "917903409",
            "telephone_number": "626-338-8407",
            "fax_number": "626-338-3937"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "910 S SUNSET AVE",
            "address_2": "SUITE 8",
            "city": "WEST COVINA",
            "state": "CA",
            "postal_code": "917903409",
            "telephone_number": "626-338-8407",
            "fax_number": "626-338-3937"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKSHMAN D MAKANDURA MD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-01-18",
        "last_updated": "2011-01-18",
        "status": "A",
        "authorized_official_last_name": "MAKANDURA",
        "authorized_official_first_name": "LAKSHMAN",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "626-338-8407",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A49715",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Covina, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.