Individual provider Active NPI

Mayank J Vakil, M.D.

  • Specialist
  • Glendora, CA
National Provider Identifier
1861449985
Registry record updated Dec 15, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
A46053 Issued in CA
Practice address
130 W Route 66
Suite # 302
Glendora, CA 91740-6249
Phone
(626) 335-7800
Fax
(626) 335-7833
NPI assigned
May 27, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 15, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X A46053 CA Primary

Addresses

Primary practice location

130 W Route 66
Suite # 302
Glendora, CA 91740-6249

Mailing address

216 S Citrus St
#322
West Covina, CA 91791-2144
Phone (626) 335-7800

Other identifiers 1

IdentifierTypeStateIssuer
AZ788YOtherCAMEDICARE PTAN

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
I20040329001727 CA Practitioner - Hematology/Oncology 3072403484 Reassigns benefits to 1 organization
Practice locations: Glendora, CA

Care Compare profile

Medicare Care Compare
Specialty
Hematology/Oncology
Education
Other, 1980
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

130 W Route 66 302
Glendora, CA 91740-6252
Phone (626) 915-1514

216 S Citrus St
Suite 322
West Covina, CA 91791-2144

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
46053CAMDDentist
A46053CAMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
City of Hope Medical Foundation CurrentSince Jun 16, 2015 Accepting new patients
Emanate Health Medical Center Past Accepting new patients
Pomona Valley Hospital Medical Center Past Accepting new patients
St. Joseph Health Northern California, LLC Past Accepting new patients
Emanate Health Medical Center Past Accepting new patients

Locations

210 S Grand Ave
Ste 425
Glendora, CA 91741
Phone (626) 335-0213

412 W Carroll Ave
Ste 210
Glendora, CA 91741
Phone (626) 335-2277

1502 Arrow Hwy
La Verne, CA 91750
Phone (909) 593-4333

6939 Palm Ct
Riverside, CA 92506
Phone (760) 416-4832

209 Fair Oaks Ave
South Pasadena, CA 91030
Phone (626) 359-8111

1250 S Sunset Ave
Ste 303
West Covina, CA 91790
Phone (626) 856-5658

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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1148688000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1418601600000",
    "number": "1861449985",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "216 S CITRUS ST",
            "address_2": "#322",
            "city": "WEST COVINA",
            "state": "CA",
            "postal_code": "917912144",
            "telephone_number": "626-335-7800",
            "fax_number": "626-335-7833"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 W ROUTE 66",
            "address_2": "SUITE # 302",
            "city": "GLENDORA",
            "state": "CA",
            "postal_code": "917406249",
            "telephone_number": "626-335-7800",
            "fax_number": "626-335-7833"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAKIL",
        "first_name": "MAYANK",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-27",
        "last_updated": "2014-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CA",
            "license": "A46053",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "AZ788Y",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendora, CA

Sources for this page

Verify at the official NPI Registry.