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General NPI Number Information
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NPI Number | 1861818239
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Entity Type | Organization
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Legal Business Name | LAMPA MEDICAL, INC.
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Dates
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Enumeration Date | 03/10/2014
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Last Update Date | 03/10/2014
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Provider Practice Location Address
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Address Line | 1930 TIENDA DR SUITE 204
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City | LODI
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State | CA
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Zip | 95242-3933
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Country | US
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Telephone | 209-333-9950
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Fax | 209-333-9948
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Provider Business Mailing Address
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Address Line | 1930 TIENDA DR SUITE 204
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City | LODI
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State | CA
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Zip | 95242-3933
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Country | US
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Telephone | 209-333-9950
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Fax | 209-333-9948
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Authorized Official
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Title or Position | OWNER
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Name | DR. WALTER JOSEPH LAMPA
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Credential | MD
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Telephone | 209-333-9950
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | 128829
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License Number State | CA
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