Provider Demographics
NPI:1366523441
Name:RASIAH, LAKSHMAN WYRAMUTTOO (MD)
Entity type:Individual
Prefix:
First Name:LAKSHMAN
Middle Name:WYRAMUTTOO
Last Name:RASIAH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1633
Mailing Address - Street 2:
Mailing Address - City:OJAI
Mailing Address - State:CA
Mailing Address - Zip Code:93024-1633
Mailing Address - Country:US
Mailing Address - Phone:805-646-4043
Mailing Address - Fax:805-646-4153
Practice Address - Street 1:206 NORTHSIGNAL STREET
Practice Address - Street 2:SUITE B
Practice Address - City:OJAI
Practice Address - State:CA
Practice Address - Zip Code:93023-2656
Practice Address - Country:US
Practice Address - Phone:805-646-4043
Practice Address - Fax:805-646-4153
Is Sole Proprietor?:No
Enumeration Date:2006-10-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC410272084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00C410270Medicaid
CAA37505Medicare UPIN
CAC41027Medicare ID - Type Unspecified