Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223S0112X | Oral and Maxillofacial Surgeon | 034139 | CA |
NPI | 1053338087 |
---|---|
Provider Name | Azeem K. Lakha |
First Address | Palo Alto, CA 94301-2602 |
Second Address | Palo Alto, CA 94301-2602 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/07/2006 |
Last Update Date | 12/08/2010 |