Provider Demographics
NPI:1235419342
Name:BANKA, LORI PRAKASH (DO)
Entity type:Individual
Prefix:DR
First Name:LORI
Middle Name:PRAKASH
Last Name:BANKA
Suffix:
Gender:
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:23600 TELO AVE STE 130
Mailing Address - Street 2:
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90505-4036
Mailing Address - Country:US
Mailing Address - Phone:310-833-1334
Mailing Address - Fax:310-833-0270
Practice Address - Street 1:23600 TELO AVE STE 130
Practice Address - Street 2:
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90505-4036
Practice Address - Country:US
Practice Address - Phone:310-833-1334
Practice Address - Fax:310-833-0270
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-19
Last Update Date:2025-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A12541207KA0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207KA0200XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyAllergy