Lake Medical Clinic, Inc. in Lake Oswego - Medical Specialty
Lake Medical Clinic, Inc. - NPI 1871693564
Lake Medical Clinic, Inc. is a Medical Specialty in Lake Oswego, Oregon. Lake Medical Clinic, Inc. practices all healthcare services and medical treatments related to Medical Specialty. The NPI Number for Lake Medical Clinic, Inc. is 1871693564. The last update date is 2020-08-22.
Lake Medical Clinic, Inc.'s current location address is Po Box 365, Lake Oswego, Oregon. You can contact this provider via phone number 5036355044 and fax number 5036353255. The mailing address for Lake Medical Clinic, Inc. is Po Box 365, Lake Oswego, Oregon. To know further, please read the information below!
Provider Profile Detail
| Provider Organization | Lake Medical Clinic, Inc. |
|---|---|
| Address | Po Box 365, Lake Oswego, Oregon |
| Phone Number | 5036355044 |
| Fax Number | 5036353255 |
| Sole Proprietor | -- |
| Credentials | -- |
Authorized Official
| Title or Position | VICE PRESI |
|---|---|
| Authorized Official Name | Conrad E Edward |
| Credentials | MD |
| Telephone Number | 5036355044 |
NPI Number Detail
| NPI Number | 1871693564 |
|---|---|
| Provider Enumeration Date | 2006-09-23 |
| Last Updated Date | 2020-08-22 |
Provider Mailing Address Detail
| Address | Po Box 365 |
|---|---|
| City | Lake Oswego |
| State | Oregon (OR) |
| Post Code | 970340042 |
| Phone Number | 5036355044 |
| Fax Number | 5036353255 |
Provider's Primary Taxonomy Detail
| Speciality | Medical Specialty |
|---|---|
| Taxonomy | 261Qm2500X |
| Licence No | 12913 |
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Definition: An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to a specific area of medical specialization. Frequently used for Title V related Children's Specialty services or to meet specific |
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What is the Lake Medical Clinic, Inc.'s 1871693564?
The Lake Medical Clinic, Inc.'s NPI (National Provider Identifier) Number is 1871693564. This unique 10-digit identification number is assigned to health care providers by the Centers for Medicare & Medicaid Services (CMS).
Can you provide the Lake Medical Clinic, Inc.'s physical address?
The Lake Medical Clinic, Inc. is physically located at Po Box 365, in the city of Lake Oswego, OR, with the postal code 970340042.
What is Lake Medical Clinic, Inc.'s specialized area of practice, and what is the corresponding taxonomy classification code for this field?
The Lake Medical Clinic, Inc.'s specialized field of practice is Medical Specialty, and the corresponding taxonomy code that categorizes this area of specialization is 261Qm2500X.
On what date did the Centers for Medicare & Medicaid Services assign the 1871693564 to Lake Medical Clinic, Inc.?
The Centers for Medicare & Medicaid Services assigned the 1871693564 to Lake Medical Clinic, Inc. on 2006-09-23.
As of what date was the information regarding Lake Medical Clinic, Inc., such as address, specialty, and other details, last verified and confirmed to be up-to-date?
The information related to Lake Medical Clinic, Inc., including its address, specialty, and other relevant details, was last verified and confirmed to be up-to-date on 2020-08-22.