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General NPI Number Information
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NPI Number | 1669900536
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Entity Type | Individual
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Provider Name | MALCOLM LAKDAWALA
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Gender | Male
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Dates
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Enumeration Date | 05/23/2017
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Last Update Date | 06/20/2025
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Provider Practice Location Address
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Address Line | 8767 WILSHIRE BLVD FL 2
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City | BEVERLY HILLS
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State | CA
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Zip | 90211-2714
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Country | US
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Telephone | 424-315-1051
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 844658
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City | DALLAS
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State | TX
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Zip | 75284-4658
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Country | US
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Telephone | 254-724-2111
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | T2422
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | A164200
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License Number State | CA
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