Provider Demographics
NPI:1235439951
Name:LAKSHMAN, MEYYAMMAI (RPH)
Entity Type:Individual
Prefix:MS
First Name:MEYYAMMAI
Middle Name:
Last Name:LAKSHMAN
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3100 FOWLER AVE
Mailing Address - Street 2:
Mailing Address - City:CLOVIS
Mailing Address - State:CA
Mailing Address - Zip Code:93611-2100
Mailing Address - Country:US
Mailing Address - Phone:559-294-6730
Mailing Address - Fax:
Practice Address - Street 1:3100 FOWLER AVE
Practice Address - Street 2:
Practice Address - City:CLOVIS
Practice Address - State:CA
Practice Address - Zip Code:93611-2100
Practice Address - Country:US
Practice Address - Phone:559-294-6730
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-10-27
Last Update Date:2010-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA56508183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist