Madhure Manjunath, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

A29758 Issued in CA

Practice address

11627 E. Telegraph Rd.,
Suite 140
Santa Fe Springs, CA 90670

Phone

(562) 949-3888

Fax

(562) 949-4858

NPI assigned

Jan 12, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Doctor of Medicine

Practice roles

Interoperability endpoints

• Direct secure messaging: madhure.manjunath.p1@direct.lakeside.nextgenshare.com

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.

• SCC Medical Center Inc

  • Internal Medicine Physician
  • Buena Park, CA
  • NPI 1902917156
  NPD (past)

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

{
    "created_epoch": "1168560000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1770634362",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11627 E. TELEGRAPH RD.,",
            "address_2": "SUITE 140",
            "city": "SANTA FE SPRINGS",
            "state": "CA",
            "postal_code": "90670",
            "telephone_number": "562-949-3888",
            "fax_number": "562-949-4858"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11627 E. TELEGRAPH RD.,",
            "address_2": "SUITE 140",
            "city": "SANTA FE SPRINGS",
            "state": "CA",
            "postal_code": "90670",
            "telephone_number": "562-949-3888",
            "fax_number": "562-949-4858"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANJUNATH",
        "first_name": "MADHURE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A29758",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A297580",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Guadalupe Maldonado
• Jesse Maldonado
• Kimberly Mae Malz, AMFT138088
• Janae Yvonne Mancilla I
• Neil Manering, MD
• Manuel D Gonzalez, O.D., Inc
• Rebeca Sarai Manzanilla
• Emily Manzo
• Ruth Haviva Maouda
• Bishop Marchian, CMPSS

• Family Medicine Physician in Santa Fe Springs, CA
• Providers in Santa Fe Springs, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.