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NPI Code Detail

MEDICARE: DR. LAKSHMY MATHUR VYTHILINGAM M.D.

MEDICARE: DR. LAKSHMY MATHUR VYTHILINGAM M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208600000XSurgery Physician227213NY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1245224450
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. LAKSHMY MATHUR VYTHILINGAM M.D.
Provider Business Mailing Address
First Line : 1611 MOUNTAIN SHADOW DR
Second Line :
City : CARLSBAD
State : NM
Zip : 88220-4154
Country : US
Telephone Number : 718-801-1770
Fax Number :
Provider Business Practice Location Address
First Line : 2430 W PIERCE ST
Second Line :
City : CARLSBAD
State : NM
Zip : 88220-3553
Country : US
Telephone Number : 575-887-4504
Fax Number : 575-628-5080
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/01/2005
Last Update Date : 09/09/2020

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