Tiyyagura, Lakshma R

Tiyyagura, Lakshma R is an sole proprietor health care provider with primary practice located at 420 W Acacia St # 18, Stockton CA 95203-2441. He recently has only one registered license in Allopathic & Osteopathic Physicians / Gastroenterology, which is considered as his primary health care specialty. Tiyyagura, Lakshma R can be contacted via phone (209) 466-4685.

Contact Information

Primary practice address
420 W Acacia St # 18 Stockton CA 95203-2441
Phone: (209) 466-4685
Fax: (209) 466-4695
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Gastroenterology 207RG0100X A56285 California

Profile Details

NPI number 1164527883
LBN Legal business name Tiyyagura, Lakshma R
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Sep 14th, 2006
Last updated May 11th, 2009 - about 15 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1164527883 NPPES
California MEDICAID 00A562851
California MEDICAID 00A562850

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