Healthcare Provider Details

I. General information

NPI: 1922188069
Provider Name (Legal Business Name): MICHAEL LEKAWA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/16/2006
Last Update Date: 02/26/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

UCI MEDICAL CENTER 101 THE CITY DRIVE SOUTH
ORANGE CA
92868
US

IV. Provider business mailing address

UNIVERSITY SURGEONS OF ORANGE PO BOX 512347
LOS ANGELES CA
90051-0347
US

V. Phone/Fax

Practice location:
  • Phone: 714-456-8978
  • Fax:
Mailing address:
  • Phone: 714-456-6369
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2086S0102X
TaxonomySurgical Critical Care Physician
License Number000000G74848
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: