Provider Demographics
NPI:1629630652
Name:LAMICHHANE, SHRISTI (MD)
Entity type:Individual
Prefix:
First Name:SHRISTI
Middle Name:
Last Name:LAMICHHANE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:SHRISTI
Other - Middle Name:
Other - Last Name:LAMICHHANE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:3660 ARLINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92506-3987
Mailing Address - Country:US
Mailing Address - Phone:951-782-3617
Mailing Address - Fax:951-784-3272
Practice Address - Street 1:7117 BROCKTON AVE
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92506-2658
Practice Address - Country:US
Practice Address - Phone:951-782-3617
Practice Address - Fax:951-784-3272
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-29
Last Update Date:2025-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
CAA201371207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & MetabolismGroup - Multi-Specialty
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program