Organization Active NPI

Makam Medical Corporation

Doing business as Anaheim Nuclear CT/ PET Imaging Center

  • Cardiovascular Disease Physician
  • Anaheim, CA
National Provider Identifier
1821132655
Registry record updated Aug 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
A40900 Issued in CA
Legal business name
MAKAM MEDICAL CORPORATION
Doing business as
Anaheim Nuclear CT/ PET Imaging Center
Practice address
1120 W la Palma Ave
14
Anaheim, CA 92801
Phone
(714) 774-9747
Fax
(714) 774-0921
NPI assigned
Feb 16, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 25, 2025

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

Authorized official

Name
Ravi P Makam, MD FACCNPI 1720070527
Title
Medical Doctor
Phone
(714) 774-9747

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
Cardiovascular Disease PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RC0000X A40900 CA Primary

Addresses

Primary practice location

1120 W la Palma Ave
14
Anaheim, CA 92801

Mailing address

1120 W la Palma Ave
14
Anaheim, CA 92801
Phone (714) 774-9747

Other identifiers 1

IdentifierTypeStateIssuer
00A409000MedicaidCA

Other names 1

  • Anaheim Nuclear CT/ PET Imaging Center Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120419000424 CA Part B Supplier - Clinic/Group Practice 6507027422 Receives reassigned benefits from 2 practitioners
Practice locations: Anaheim, CA

National Provider Directory

National Provider Directory

Locations

1120 W La Palma Ave
Ste 14
Anaheim, CA 92801
Phone (714) 774-9747

Networks

  • BSC 65 PLUS INDIVIDUAL MAPDPlans: Blue Shield 65 Plus (HMO) (H0504-015-000, H0504); Blue Shield 65 Plus (HMO) (H0504-039-000, H0504); Blue Shield 65 Plus Plan 2 (HMO) (H0504-021-000, H0504); Blue Shield Inspire (HMO) (H0504-041-000, H0504); Blue Shield 65 Plus (HMO) (H0504-038-000, H0504); Blue Shield Inspire (HMO) (H0504-047-000, H0504); Blue Shield 65 Plus (HMO) (H0504-026-000, H0504); Blue Shield Advantage (HMO) (H0504-050-000, H0504); Blue Shield AdvantageOptimum Plan (HMO) (H5928-004-000, H5928); Blue Shield Inspire (HMO) (H0504-043-000, H0504)…

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1171584000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1756080000000",
    "number": "1821132655",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1120 W LA PALMA AVE",
            "address_2": "14",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "92801",
            "telephone_number": "714-774-9747",
            "fax_number": "714-774-0921"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1120 W LA PALMA AVE",
            "address_2": "14",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "92801",
            "telephone_number": "714-774-9747",
            "fax_number": "714-774-0921"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAKAM MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-16",
        "last_updated": "2025-08-25",
        "certification_date": "2025-08-25",
        "status": "A",
        "authorized_official_last_name": "MAKAM",
        "authorized_official_first_name": "RAVI",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "MEDICAL DOCTOR",
        "authorized_official_telephone_number": "714-774-9747",
        "authorized_official_credential": "MD FACC"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "CA",
            "license": "A40900",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A409000",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Anaheim Nuclear CT/ PET Imaging Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Anaheim, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.