Individual provider Active NPI

Gayathri Selvakkumaran, MD.

  • Pediatrics Physician
  • San Gabriel, CA
National Provider Identifier
1730472739
Registry record updated Aug 27, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
A114147 Issued in CA
Practice address
207 S Santa Anita Ave
San Gabriel, CA 91776-1146
Phone
(626) 576-0800
NPI assigned
May 24, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X A114147 CA Primary

Addresses

Primary practice location

207 S Santa Anita Ave
San Gabriel, CA 91776-1146

Mailing address

PO Box 9602
Mission Hills, CA 91346-9602
Phone (818) 837-5637

Other identifiers 1

IdentifierTypeStateIssuer
00A1141470MedicaidCA

Other names 1

  • Gayathri Arumugam Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120625000697 CA Practitioner - Pediatric Medicine 7113182130 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A114147CAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Southern California Permanente Medical Group CurrentSince Nov 7, 2022 Accepting new patients
Southern California Permanente Medical Group CurrentSince Nov 7, 2022 Accepting new patients
Mayflower Medical Group, Inc. Pediatrics Past Accepting new patients
Usc Arcadia Hospital Past Accepting new patients
Ahmc San Gabriel Valley Medical Past Accepting new patients

Locations

393 E Walnut St
Fl 3
Pasadena, CA 91188
Phone (626) 405-7914

1255 W Arrow Hwy
San Dimas, CA 91773
Phone (909) 394-2526

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 5

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": "1306195200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1346025600000",
    "number": "1730472739",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9602",
            "city": "MISSION HILLS",
            "state": "CA",
            "postal_code": "913469602",
            "telephone_number": "818-837-5637",
            "fax_number": "818-837-5589"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "207 S SANTA ANITA AVE",
            "city": "SAN GABRIEL",
            "state": "CA",
            "postal_code": "917761146",
            "telephone_number": "626-576-0800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SELVAKKUMARAN",
        "first_name": "GAYATHRI",
        "credential": "MD.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-05-24",
        "last_updated": "2012-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A114147",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A1141470",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "GAYATHRI",
            "last_name": "ARUMUGAM",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in San Gabriel, CA

Sources for this page

Verify at the official NPI Registry.