| Lake Community Medical Group, Inc. | |
|
596 N Lake Ave Suite 201 Pasadena CA 91101-1455 | |
| (626) 405-0449 | |
| (626) 405-0439 |
| Full Name | Lake Community Medical Group, Inc. |
|---|---|
| Speciality | Family Medicine |
| Location | 596 N Lake Ave, Pasadena, California |
| Authorized Official Name and Position | Stephen M Levine (PRESIDENT) |
| Authorized Official Contact | 6264050449 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lake Community Medical Group, Inc. 596 N Lake Ave Suite 201 Pasadena CA 91101-1455 Ph: (626) 405-0449 | Lake Community Medical Group, Inc. 596 N Lake Ave Suite 201 Pasadena CA 91101-1455 Ph: (626) 405-0449 |
| NPI Number | 1699062927 |
|---|---|
| Provider Enumeration Date | 07/07/2011 |
| Last Update Date | 07/07/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1699062927 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
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