| Lakshmi S Shukla Md Fccp Inc | |
|
320 Superior #240 Newport Beach CA 92663 | |
| (949) 548-5111 | |
| (949) 548-2575 |
| Full Name | Lakshmi S Shukla Md Fccp Inc |
|---|---|
| Speciality | Internal Medicine |
| Location | 320 Superior, Newport Beach, California |
| Authorized Official Name and Position | Lakshmi S Shukla (PRESIDENT) |
| Authorized Official Contact | 9495485111 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lakshmi S Shukla Md Fccp Inc 320 Superior #240 Newport Beach CA 92663 Ph: (949) 548-5111 | Lakshmi S Shukla Md Fccp Inc 320 Superior #240 Newport Beach CA 92663 Ph: (949) 548-5111 |
| NPI Number | 1225061799 |
|---|---|
| Provider Enumeration Date | 07/08/2006 |
| Last Update Date | 08/22/2020 |
| Medicare PECOS PAC ID | 6709919525 |
|---|---|
| Medicare Enrollment ID | O20100730000671 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1225061799 | NPI | - | NPPES |
| 00A339930 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | A33993 (California) | Primary |
| 207RP1001X | Internal Medicine - Pulmonary Disease | A33993 (California) | Primary |
| Provider Name | Lakshmi S Shukla |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1407043243 PECOS PAC ID: 2668505496 Enrollment ID: I20100730000734 |
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