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1245694462 NPI number — LAKSHMANAN SIVASUNDARAM

NPI Number: 1245694462
Health Care Provider/Practitioner: LAKSHMANAN SIVASUNDARAM

Information about “1245694462” NPI (LAKSHMANAN SIVASUNDARAM) exists in 1245694462 in HTML format HTML  |  1245694462 in plain Text format TXT  |  1245694462 in PDF (Portable Document Format) PDF  |  1245694462 in an XML format XML  formats.

NPI Number : 1245694462 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1245694462",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "SIVASUNDARAM",
    "FirstName": "LAKSHMANAN",
    "MiddleName": null,
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": null,
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "1203 FLYNN RD UNIT 160",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "CAMARILLO",
    "MailingAddressStateName": "CA",
    "MailingAddressPostalCode": "93012-6203",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "805-804-4168",
    "MailingAddressFaxNumber": "805-830-1177",
    "FirstLinePracticeLocationAddress": "2525 ERRINGER RD",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "SIMI VALLEY",
    "PracticeLocationAddressStateName": "CA",
    "PracticeLocationAddressPostalCode": "93065-2352",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "805-527-1404",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "04/13/2016",
    "LastUpdateDate": "07/14/2025",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "M",
    "Gender": "Male",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "207X00000X",
          "TaxonomyName": "Orthopaedic Surgery Physician",
          "LicenseNumber": "A175877",
          "LicenseNumberStateCode": "CA",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "207XX0005X",
          "TaxonomyName": "Sports Medicine (Orthopaedic Surgery) Physician",
          "LicenseNumber": "A175877",
          "LicenseNumberStateCode": "CA",
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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