Lakeside Pharmacy

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

PHY47386 Issued in CA

Legal business name

LAKESIDE PHARMACY

Practice address

31681 Riverside Dr
Ste D
Lake Elsinore, CA 92530-7815

Phone

(951) 245-7699

Fax

(951) 245-7721

NPI assigned

Aug 20, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Sharon Hutton

Title

Owner

Phone

(951) 245-7699

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1156032000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1215475200000",
    "number": "1063527018",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31681 RIVERSIDE DR",
            "address_2": "STE D",
            "city": "LAKE ELSINORE",
            "state": "CA",
            "postal_code": "925307815"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31681 RIVERSIDE DR",
            "address_2": "STE D",
            "city": "LAKE ELSINORE",
            "state": "CA",
            "postal_code": "925307815",
            "telephone_number": "951-245-7699",
            "fax_number": "951-245-7721"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKESIDE PHARMACY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-20",
        "last_updated": "2008-07-08",
        "status": "A",
        "authorized_official_last_name": "HUTTON",
        "authorized_official_first_name": "SHARON",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "951-245-7699"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "CA",
            "license": "PHY47386",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER-COMMERCIAL NUMBER",
            "identifier": "5623283",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lake Elsinore Diagnostics
• Lake Elsinore Unified School District
• Lake Elsinore Urgent Care Center
• Lakeshore Medical Clinic Inc
• Lakeshore Medical Clinic Inc
• Amanda Sophie Lam
• Patricia Lamas
• Katherine N Landeros, MA
• Kayla Dianne Langworthy
• Marilyn Oyan Lapaix

• Community/Retail Pharmacy in Lake Elsinore, CA
• Providers in Lake Elsinore, CA by specialty
• Community/Retail Pharmacy in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.