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General NPI Number Information
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NPI Number | 1982745758
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Entity Type | Individual
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Provider Name | LAKSHMI DHANVANTHARI M.D., FAAP, CHIE
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Gender | Female
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Dates
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Enumeration Date | 02/12/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 5151 CAMINO RUIZ STE A MS CACC01 008
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City | CAMARILLO
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State | CA
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Zip | 93012-8648
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Country | US
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Telephone | 805-384-7855
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Fax | 805-383-1799
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Provider Business Mailing Address
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Address Line | 5151 CAMINO RUIZ STE A MS CACC01 0008
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City | CAMARILLO
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State | CA
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Zip | 93012-8648
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Country | US
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Telephone | 805-384-7855
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Fax | 805-383-1799
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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 | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | A50451
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | M3519
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 0101236298
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License Number State | VA
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Taxonomy #4
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 21523
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License Number State | WV
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