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EAST LAKE MEDICAL LLC NPI 1700121464


NPI Information

NPI: 1700121464
Provider Name: EAST LAKE MEDICAL, LLC
Classification: Internal Medicine - 207RP1001X
Entity Type: Organization

Specialization: Pulmonary Disease

Address:
841 KUHN DR STE 200
CHULA VISTA, CA
ZIP 91914
Phone: (619) 482-7301
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EAST LAKE MEDICAL, LLC is a pulmonary disease internal medicine in Chula Vista, CA. The provider is an internist who treats diseases of the lungs and airways. The pulmonologist diagnoses and treats cancer, pneumonia, pleurisy, asthma, occupational and environmental diseases, bronchitis, sleep disorders, emphysema and other complex disorders of the lungs. EAST LAKE MEDICAL, LLC NPI is 1700121464. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

841 KUHN DR STE 200
CHULA VISTA, CA
ZIP 91914-523
Phone: (619) 482-7301
Fax: (619) 482-6950

The provider's authorized official is Martha E Lozano .
The authorized official title is President and has the following contact phone number (619) 482-7301.

The enumeration date for this NPI number is 12/6/2012 and was last updated on 12/6/2012.


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
1207RP1001XInternal MedicinePulmonary DiseaseA48551CALIFORNIAYes

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
1E52093MEDICARE UPIN
2WA48551AMEDICARE PIN
300A485510MEDICAIDCALIFORNIA

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

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