Locklab Provider Group, LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

LOCKLAB PROVIDER GROUP, LLC

Practice address

780 Commercial St SE Ste 100
Salem, OR 97301-3465

Phone

(305) 425-9125

NPI assigned

May 19, 2026

Organization subpart

No

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

Authorized official

Name

Dr. Bobby Desai, MD

Title

President

Phone

(305) 425-9125

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1779148800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1779148800000",
    "number": "1376472910",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10260 SW GREENBURG RD STE 400",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972235514",
            "telephone_number": "305-425-9125"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "780 COMMERCIAL ST SE STE 100",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973013465",
            "telephone_number": "305-425-9125"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LOCKLAB PROVIDER GROUP, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-05-19",
        "last_updated": "2026-05-19",
        "certification_date": "2026-05-19",
        "status": "A",
        "authorized_official_last_name": "DESAI",
        "authorized_official_first_name": "BOBBY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "305-425-9125",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dinah Loa, M.D.
• Heather Loch, RD, LD
• Kelsey Locken, PA-C, RT(R)
• Toni Lynn Locker, MSW, LCSW
• Lacey Beth Lockhart
• Jeffrey Lockwood, RN/CRNA
• Holly Loescher, HAS-P, COHC
• Ian Loewen-Thomas, M.D.
• David T Loewen
• Ward Aaron Lofgren, MS, LPC, CADCI

• Family Medicine Physician in Salem, OR
• Providers in Salem, OR by specialty
• Family Medicine Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2026; 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.