Provider Demographics
NPI:1487180568
Name:LAMA, BIMALA
Entity Type:Individual
Prefix:
First Name:BIMALA
Middle Name:
Last Name:LAMA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4852 S BRADLEY RD
Mailing Address - Street 2:
Mailing Address - City:SANTA MARIA
Mailing Address - State:CA
Mailing Address - Zip Code:93455-5048
Mailing Address - Country:US
Mailing Address - Phone:805-938-9994
Mailing Address - Fax:805-938-9745
Practice Address - Street 1:4852 S BRADLEY RD
Practice Address - Street 2:
Practice Address - City:SANTA MARIA
Practice Address - State:CA
Practice Address - Zip Code:93455-5048
Practice Address - Country:US
Practice Address - Phone:805-938-9994
Practice Address - Fax:805-938-9745
Is Sole Proprietor?:Yes
Enumeration Date:2017-05-10
Last Update Date:2017-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA64038183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist