Provider Demographics
NPI:1578521266
Name:PANDIT, LALITA HEMANT (MD)
Entity Type:Individual
Prefix:DR
First Name:LALITA
Middle Name:HEMANT
Last Name:PANDIT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11180 WARNER AVE
Mailing Address - Street 2:STE 467
Mailing Address - City:FOUNTAIN VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92708-7505
Mailing Address - Country:US
Mailing Address - Phone:714-432-9200
Mailing Address - Fax:844-267-7896
Practice Address - Street 1:11180 WARNER AVE
Practice Address - Street 2:STE 467
Practice Address - City:FOUNTAIN VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92708-7505
Practice Address - Country:US
Practice Address - Phone:714-432-9200
Practice Address - Fax:714-432-9210
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-02
Last Update Date:2019-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA47707207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A477070Medicaid
CAA47707Medicare ID - Type Unspecified
CAG09558Medicare UPIN