LASALLE MEDICAL ASSOCIATES NPI 1548398142

NPI Information

NPI: 1548398142
Provider Name: LASALLE MEDICAL ASSOCIATES
Classification: Clinic/Center - 261QM1300X
Entity Type: Organization

Specialization: Multi-Specialty

CLIA Number: 05D0575267

Address:
1505 W. 17TH STREET
SAN BERNARDINO, CA
ZIP 92411
Phone: (909) 887-6494
Get Directions

LASALLE MEDICAL ASSOCIATES is a multi-specialty clinic center in San Bernardino, CA. LASALLE MEDICAL ASSOCIATES NPI is 1548398142. The provider is registered as an organization entity type.

The provider's business location address is:

1505 W. 17TH STREET
SAN BERNARDINO, CA
ZIP 92411
Phone: (909) 887-6494
Fax: (909) 887-6043

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 05D0575267 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 3/2/2007 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			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	GR0079091	MEDICAID	CALIFORNIA
2	00A382060	OTHER	CALIFORNIA	MEDI-CAL ID NUMBER

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: 11/14/2023

NPI Synchronization or Removal

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