Provider Demographics
NPI:1902092034
Name:LAKHA, RUMI K (DO)
Entity Type:Individual
Prefix:
First Name:RUMI
Middle Name:K
Last Name:LAKHA
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7136 PACIFIC BLVD
Mailing Address - Street 2:#225
Mailing Address - City:HUNTINGTON PARK
Mailing Address - State:CA
Mailing Address - Zip Code:90255-4783
Mailing Address - Country:US
Mailing Address - Phone:323-588-5467
Mailing Address - Fax:
Practice Address - Street 1:7136 PACIFIC BLVD
Practice Address - Street 2:#225
Practice Address - City:HUNTINGTON PARK
Practice Address - State:CA
Practice Address - Zip Code:90255-4783
Practice Address - Country:US
Practice Address - Phone:323-588-5467
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-21
Last Update Date:2007-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A5074207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00AX50740Medicaid
CA00AX50741Medicaid
CA20A5074BMedicare PIN