Provider Demographics
NPI:1245408921
Name:CHARANJIT K. LAMBA M.D. P.S.
Entity Type:Organization
Organization Name:CHARANJIT K. LAMBA M.D. P.S.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CHARANJIT
Authorized Official - Middle Name:K
Authorized Official - Last Name:LAMBA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:253-839-0413
Mailing Address - Street 1:24703 38TH AVE S
Mailing Address - Street 2:
Mailing Address - City:KENT
Mailing Address - State:WA
Mailing Address - Zip Code:98032-4111
Mailing Address - Country:US
Mailing Address - Phone:253-839-0413
Mailing Address - Fax:
Practice Address - Street 1:24703 38TH AVE S
Practice Address - Street 2:
Practice Address - City:KENT
Practice Address - State:WA
Practice Address - Zip Code:98032-4111
Practice Address - Country:US
Practice Address - Phone:253-839-0413
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-14
Last Update Date:2008-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00020975261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1046994OtherMEDICAID
WA44320OtherL&I
WALA4631OtherREGENCE BLUE SHIELD
WA751OtherAETNA
WA7102973Medicaid
WA7102973Medicaid
WA751OtherAETNA