Provider Demographics
NPI:1710156476
Name:MAKHANI, MARC DAVID (MD)
Entity Type:Individual
Prefix:DR
First Name:MARC
Middle Name:DAVID
Last Name:MAKHANI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:PO BOX 16659
Mailing Address - Street 2:
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90209-2659
Mailing Address - Country:US
Mailing Address - Phone:310-657-5244
Mailing Address - Fax:888-242-2683
Practice Address - Street 1:8631 W 3RD ST
Practice Address - Street 2:SUITE 445E
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90048-5901
Practice Address - Country:US
Practice Address - Phone:310-657-5244
Practice Address - Fax:888-242-2683
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-27
Last Update Date:2013-07-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA102671207R00000X, 207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA222401Medicare PIN