Active NPI
Lakeshore Medical Clinic Inc
- Internal Medicine Physician
- Lake Elsinore, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- A50401
- Legal business name
- LAKESHORE MEDICAL CLINIC INC
- Practice address
- 16770 Lakeshore Dr Ste G
Lake Elsinore, CA 92530-4953 - Phone
- (951) 674-6876
- Fax
- (951) 674-6876
- NPI assigned
- Nov 20, 2009
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Mohmedali Patel, MD
- Title
- Owner
- Phone
- (951) 674-6876
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | A50401 | CA | Primary |
Addresses
Primary practice location
16770 Lakeshore Dr Ste G
Lake Elsinore, CA 92530-4953
Mailing address
16770 Lakeshore Dr Ste G
Lake Elsinore, CA 92530-4953
Phone (951) 674-6876
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
Enrollment records 1
National Provider Directory
National Provider Directory- Tax ID family
- Lakeshore Medical Clinic Inc
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Family Medicine Physician
- Lake Elsinore, CA
- NPI 1346571502
Locations
16770 Lakeshore Dr
Ste G
Lake Elsinore, CA 92530
Phone (951) 674-6876
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Hospice and Palliative Medicine (Internal Medicine) Physician
- Lake Elsinore, CA
- NPI 1548486756
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1258675200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1258675200000",
"number": "1063740520",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "16770 LAKESHORE DR STE G",
"city": "LAKE ELSINORE",
"state": "CA",
"postal_code": "925304953",
"telephone_number": "951-674-6876",
"fax_number": "951-674-6876"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "16770 LAKESHORE DR STE G",
"city": "LAKE ELSINORE",
"state": "CA",
"postal_code": "925304953",
"telephone_number": "951-674-6876",
"fax_number": "951-674-6876"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "LAKESHORE MEDICAL CLINIC INC",
"organizational_subpart": "NO",
"enumeration_date": "2009-11-20",
"last_updated": "2009-11-20",
"status": "A",
"authorized_official_last_name": "PATEL",
"authorized_official_first_name": "MOHMEDALI",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "951-674-6876",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "MD"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Internal Medicine",
"state": "CA",
"license": "A50401",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lake Elsinore, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.