LASALLE MEDICAL ASSOCIATES NPI 1447388251

NPI Information

NPI: 1447388251
Provider Name: LASALLE MEDICAL ASSOCIATES
Classification: Clinic/Center - 261QM1300X
Entity Type: Organization

Specialization: Multi-Specialty

CLIA Number: 05D0983476

Address:
565 N. MT. VERNON AVE.
SAN BERNARDINO, CA
ZIP 92411
Phone: (909) 884-9091
Get Directions

LASALLE MEDICAL ASSOCIATES is a multi-specialty clinic center in San Bernardino, CA. LASALLE MEDICAL ASSOCIATES NPI is 1447388251. The provider is registered as an organization entity type.

The provider's business location address is:

565 N. MT. VERNON AVE.
SAN BERNARDINO, CA
ZIP 92411-661
Phone: (909) 884-9091
Fax: (909) 383-7013

The provider's authorized official is Albert H. Arteaga .
The authorized official title is Ceo/owner and has the following contact phone number (909) 890-0407.

The CLIA number assigned to this NPI record is 05D0983476 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 3/1/2007 and was last updated on 8/23/2016.

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:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QM1300X	Clinic/Center	Multi-Specialty	A31849	CALIFORNIA	No
2	261QM1300X	Clinic/Center	Multi-Specialty			No
3	261QM1300X	Clinic/Center	Multi-Specialty	A38206	CALIFORNIA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	00A382060	OTHER	CALIFORNIA	MEDI-CAL ID NUMBER
2	P00014299	OTHER	CALIFORNIA	RAILROAD MEDICARE UPIN
3	ZZZ16166Z	MEDICARE UPIN	CALIFORNIA
4	GR0079095	MEDICAID	CALIFORNIA
5	P00014299	OTHER	CALIFORNIA	RR MEDICARE PIN
6	ZZZ16166Z	MEDICARE PIN	CALIFORNIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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