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Organization
LAKSHMI K AVALA MD INC
Active
Organization
LAKSHMI K AVALA MD INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LAKSHMI KUMARI AVALA MD (OWNER)
(916) 722-4565
Entity
Organization
Contact information
Practice address
5959 GREENBACK LN STE 210, CITRUS HEIGHTS, CA 95621-4700
(916) 722-4565
(916) 722-5213
Mailing address
5959 GREENBACK LN STE 210, CITRUS HEIGHTS, CA 95621-4700
(916) 722-4565
(916) 722-5213
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
A79103
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
A79103
CALIFORNIA MEDICAL LICENSE
CA
Enumeration date
05/21/2018
Last updated
05/21/2018
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