Provider Demographics
NPI:1437248846
Name:LEKAWA, DEEPIKA SAJEE (MD)
Entity Type:Individual
Prefix:
First Name:DEEPIKA
Middle Name:SAJEE
Last Name:LEKAWA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:DEEPIKA
Other - Middle Name:SAJEE
Other - Last Name:LEKAWA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:17360 BROOKHURST ST
Mailing Address - Street 2:ATTN: MCMF- CREDENTIALING DEPARTMENT
Mailing Address - City:FOUNTAIN VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92708-3720
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1451 IRVINE BLVD
Practice Address - Street 2:
Practice Address - City:TUSTIN
Practice Address - State:CA
Practice Address - Zip Code:92780-3804
Practice Address - Country:US
Practice Address - Phone:714-838-8878
Practice Address - Fax:714-838-8988
Is Sole Proprietor?:No
Enumeration Date:2006-10-12
Last Update Date:2016-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG77604207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CACB224702Medicare PIN
CAG12108Medicare UPIN