LAKE MEDICAL CENTER INC. NPI 1689863714

NPI Information

LAKE MEDICAL CENTER, INC. is a neurology psychiatry neurology in San Marcos, CA. The provider is a Neurologist specializes in the diagnosis and treatment of diseases or impaired function of the brain, spinal cord, peripheral nerves, muscles, autonomic nervous system, and blood vessels that relate to these structures. LAKE MEDICAL CENTER, INC. NPI is 1689863714. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

1146 SAN MARINO DR
SAN MARCOS, CA
ZIP 92078-649
Phone: (760) 471-2033
Fax: (760) 471-2083

The provider's authorized official is Michael Shack .
The authorized official title is President and has the following contact phone number (760) 471-2033.

The CLIA number assigned to this NPI record is 05D2080607 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 10/15/2007 and was last updated on 10/15/2007.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

Other Identifiers

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