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NPI Code Detail

MEDICARE: LOCKLAB PROVIDER GROUP CA, P.C.

MEDICARE: LOCKLAB PROVIDER GROUP CA, P.C.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine Physician

General Provider Information

NPI Number : 1225995194
Entity Type Code : Organization
Provider Name (Legal Business Name) : LOCKLAB PROVIDER GROUP CA, P.C.
Provider Business Mailing Address
First Line : 5250 LANKERSHIM BLVD STE 500
Second Line :
City : NORTH HOLLYWOOD
State : CA
Zip : 91601-3187
Country : US
Telephone Number : 305-425-9125
Fax Number :
Provider Business Practice Location Address
First Line : 5250 LANKERSHIM BLVD STE 500
Second Line :
City : NORTH HOLLYWOOD
State : CA
Zip : 91601-3187
Country : US
Telephone Number : 305-425-9125
Fax Number :
Authorized Official
Title or Position : PRESIDENT
Name : DR. BOBBY DESAI
Credential : MD
Telephone Number : 305-425-9125
Provider Enumeration Date : 01/05/2026
Last Update Date : 01/05/2026

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