Provider Demographics
NPI:1982745758
Name:DHANVANTHARI, LAKSHMI (MD, FAAP, CHIE)
Entity Type:Individual
Prefix:DR
First Name:LAKSHMI
Middle Name:
Last Name:DHANVANTHARI
Suffix:
Gender:F
Credentials:MD, FAAP, CHIE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5151 CAMINO RUIZ STE A
Mailing Address - Street 2:MS CACC01 0008
Mailing Address - City:CAMARILLO
Mailing Address - State:CA
Mailing Address - Zip Code:93012-8648
Mailing Address - Country:US
Mailing Address - Phone:805-384-7855
Mailing Address - Fax:805-383-1799
Practice Address - Street 1:5151 CAMINO RUIZ STE A
Practice Address - Street 2:MS CACC01 008
Practice Address - City:CAMARILLO
Practice Address - State:CA
Practice Address - Zip Code:93012-8648
Practice Address - Country:US
Practice Address - Phone:805-384-7855
Practice Address - Fax:805-383-1799
Is Sole Proprietor?:No
Enumeration Date:2007-02-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA50451208000000X
TXM3519208000000X
VA0101236298208000000X
WV21523208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics