Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RN0300X | Nephrologist | A127348 | CA |
N | 2080P0210X | Pediatric Nephrologist | A127348 | CA |
NPI | 1821356288 |
---|---|
Provider Name | Lakshmi Lakshmanan Ganesan |
First Address | Loma Linda, CA 92354-2804 |
Second Address | Loma Linda, CA 92354-2804 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/04/2012 |
Last Update Date | 18/11/2021 |