Active NPI
Prakash K Yakkundi, MD
- Internal Medicine Physician
- Victorville, CA
National Provider Identifier
1851350771
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- C54968
- Practice address
- 12408 Hesperia Rd
Suite 2
Victorville, CA 92395-7718 - Phone
- (760) 553-7000
- Fax
- (760) 261-6451
- NPI assigned
- Mar 20, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 35-042385 | OH | |
| Internal Medicine Physician | 207R00000X | C54968 | CA | Primary |
Addresses
Primary practice location
12408 Hesperia Rd
Suite 2
Victorville, CA 92395-7718
Mailing address
12370 Hesperia Rd
Suite 6
Victorville, CA 92395-7719
Phone (760) 245-4747
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0399724 | Medicaid | OH | |
| 34127919700 | Other | OH | WORKERS COMP |
Other names 1
- Dr. P K Yakkundi
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| C54968 | CA | MD | Internal Medicine Physician |
| 35-042385 | OH | MD | Internal Medicine Physician |
| 54968 | CA | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1142812800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1399248000000",
"number": "1851350771",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12370 HESPERIA RD",
"address_2": "SUITE 6",
"city": "VICTORVILLE",
"state": "CA",
"postal_code": "923957719",
"telephone_number": "760-245-4747",
"fax_number": "760-261-6451"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12408 HESPERIA RD",
"address_2": "SUITE 2",
"city": "VICTORVILLE",
"state": "CA",
"postal_code": "923957718",
"telephone_number": "760-553-7000",
"fax_number": "760-261-6451"
}
],
"practiceLocations": [],
"basic": {
"last_name": "YAKKUNDI",
"first_name": "PRAKASH",
"middle_name": "K",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-03-20",
"last_updated": "2014-05-05",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "OH",
"license": "35-042385",
"primary": false
},
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "CA",
"license": "C54968",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0399724",
"state": "OH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "WORKERS COMP",
"identifier": "34127919700",
"state": "OH"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "P",
"last_name": "YAKKUNDI",
"middle_name": "K",
"prefix": "DR.",
"credential": "MD",
"code": "5",
"type": "Other Name"
}
]
}Other providers in Victorville, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.