Organization
LOCKLAB PROVIDER GROUP, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BOBBY DESAI MD (PRESIDENT)
(305) 425-9125
Entity
Organization
Contact information
Practice address
780 COMMERCIAL ST SE STE 100, SALEM, OR 97301-3465
(305) 425-9125
Mailing address
10260 SW GREENBURG RD STE 400, PORTLAND, OR 97223-5514
(305) 425-9125
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
05/19/2026
Last updated
05/19/2026
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