Provider Demographics
NPI:1508185406
Name:IYER, LAXMI SUDARSHAN (MD,)
Entity Type:Individual
Prefix:DR
First Name:LAXMI
Middle Name:SUDARSHAN
Last Name:IYER
Suffix:
Gender:F
Credentials:MD,
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:6827 W TROPICANA AVE STE 110
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89103-4920
Mailing Address - Country:US
Mailing Address - Phone:800-881-4226
Mailing Address - Fax:702-960-4190
Practice Address - Street 1:4500 BROCKTON AVE STE 107
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92501-4006
Practice Address - Country:US
Practice Address - Phone:951-276-2760
Practice Address - Fax:951-276-2960
Is Sole Proprietor?:No
Enumeration Date:2010-05-18
Last Update Date:2020-06-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA165408207RX0202X, 207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
No207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology