Healthcare Provider Details

I. General information

NPI: 1346746930
Provider Name (Legal Business Name): LAKAI MONEE BANKS-DEAN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/02/2018
Last Update Date: 04/09/2026
Certification Date: 04/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1240 BROADWAY
EL CAJON CA
92021-4994
US

IV. Provider business mailing address

1240 BROADWAY
EL CAJON CA
92021-4994
US

V. Phone/Fax

Practice location:
  • Phone: 619-841-1310
  • Fax:
Mailing address:
  • Phone: 619-841-1310
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QA0401X
TaxonomyAddiction Medicine (Family Medicine) Physician
License NumberA167046
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberA176046
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number167046
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: