Provider Demographics
NPI:1497054100
Name:LAKDAWALA, RAVI SHARAD (MD)
Entity Type:Individual
Prefix:DR
First Name:RAVI
Middle Name:SHARAD
Last Name:LAKDAWALA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:8641 WILSHIRE BLVD STE 300
Mailing Address - Street 2:
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90211-2921
Mailing Address - Country:US
Mailing Address - Phone:310-652-9162
Mailing Address - Fax:310-854-7259
Practice Address - Street 1:8641 WILSHIRE BLVD STE 300
Practice Address - Street 2:
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90211-2921
Practice Address - Country:US
Practice Address - Phone:310-652-9162
Practice Address - Fax:310-854-7259
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-21
Last Update Date:2020-09-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA130619207R00000X, 207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine