Provider Demographics
NPI:1841378874
Name:LAAMBDA HEALTHCARE, INC.
Entity Type:Organization
Organization Name:LAAMBDA HEALTHCARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KAMAL
Authorized Official - Middle Name:J
Authorized Official - Last Name:MOHAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:901-767-1100
Mailing Address - Street 1:PO BOX 172327
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38187-2327
Mailing Address - Country:US
Mailing Address - Phone:901-767-1100
Mailing Address - Fax:901-761-9703
Practice Address - Street 1:6025 WALNUT GROVE RD
Practice Address - Street 2:SUITE 311
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38120-2131
Practice Address - Country:US
Practice Address - Phone:901-767-1100
Practice Address - Fax:901-761-9703
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-01
Last Update Date:2015-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
377918Medicare PIN