Healthcare Provider Details

I. General information

NPI: 1497955371
Provider Name (Legal Business Name): LAKSHMI PRIYA ESTURI M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: LAKSHMI PRIYA MAKAM

II. Dates (important events)

Enumeration Date: 07/19/2007
Last Update Date: 02/11/2022
Certification Date: 06/24/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

280 HOSPITAL PKWY
SAN JOSE CA
95119-1103
US

IV. Provider business mailing address

280 HOSPITAL PKWY
SAN JOSE CA
95119-1103
US

V. Phone/Fax

Practice location:
  • Phone: 408-972-7000
  • Fax:
Mailing address:
  • Phone: 408-972-7000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License NumberLL1821
License Number StateNV
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberM-14454
License Number StateID
# 3
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberA112574
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: