Ravi K Lakkaraju MD Inc

Primary specialty

Pain Medicine PhysicianTaxonomy code 208VP0000X

License

C55361 Issued in CA

Legal business name

RAVI K LAKKARAJU MD INC

Doing business as

Poway Spine and Pain

Practice address

15725 Pomerado Rd Ste 105
Poway, CA 92064-2057

Phone

(858) 485-1846

Fax

(858) 485-8676

NPI assigned

Jul 2, 2014

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Ravi K Lakkaraju, MD

Title

President

Phone

(858) 485-1846

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Poway Spine and Pain Doing business as

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1404259200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1404259200000",
    "number": "1245646959",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15725 POMERADO RD STE 105",
            "city": "POWAY",
            "state": "CA",
            "postal_code": "920642057",
            "telephone_number": "858-485-1846",
            "fax_number": "858-485-8676"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15725 POMERADO RD STE 105",
            "city": "POWAY",
            "state": "CA",
            "postal_code": "920642057",
            "telephone_number": "858-485-1846",
            "fax_number": "858-485-8676"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RAVI K LAKKARAJU MD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-07-02",
        "last_updated": "2014-07-02",
        "status": "A",
        "authorized_official_last_name": "LAKKARAJU",
        "authorized_official_first_name": "RAVI",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "858-485-1846",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208VP0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pain Medicine, Pain Medicine",
            "state": "CA",
            "license": "C55361",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CALIFORNIA MEDICAL LICENSE",
            "identifier": "C55361",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Poway Spine and Pain",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Soumya G Rao, M.D.
• Erela Katz Rappaport, D.M.D.
• Daniel Mark Rapps, DDS
• Rathi Investments, Inc.
• David Edward Rauterkus, DDS
• Aja Ray
• Frances Ray
• Galya Raz, D.M.D.
• Jenny Raz, LCSW
• Reid Recendiz

• Pain Medicine Physician in Poway, CA
• Providers in Poway, CA by specialty
• Pain Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.