Individual provider Active NPI

Sandra M Kochaon, PA-C

  • Medical Physician Assistant
  • West Covina, CA
National Provider Identifier
1336470871
Registry record updated Jan 22, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA 14513 Issued in CA
Practice address
910 S Sunset Ave Ste 8
West Covina, CA 91790-3409
Phone
(626) 338-8407
Fax
(626) 338-3937
NPI assigned
Jan 22, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 22, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA 14513 CA Primary

Addresses

Primary practice location

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

Mailing address

412 E Colorado Blvd
Monrovia, CA 91016-2964
Phone (626) 607-7491

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
PA 14513CAMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Lakshman D Makandura MD Inc PastSince Jun 25, 2012 Accepting new patients
Greater Valley Physicians Medical Group Inc Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1264118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1264118400000",
    "number": "1336470871",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "412 E COLORADO BLVD",
            "city": "MONROVIA",
            "state": "CA",
            "postal_code": "910162964",
            "telephone_number": "626-607-7491",
            "fax_number": "626-338-3937"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "910 S SUNSET AVE STE 8",
            "city": "WEST COVINA",
            "state": "CA",
            "postal_code": "917903409",
            "telephone_number": "626-338-8407",
            "fax_number": "626-338-3937"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOCHAON",
        "first_name": "SANDRA",
        "middle_name": "M",
        "name_prefix": "Miss",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-01-22",
        "last_updated": "2010-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CA",
            "license": "PA 14513",
            "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 22, 2010; 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.