Lake Elsinore Diagnostics

Primary specialty

Radiology Clinic/CenterTaxonomy code 261QR0200X

License

A73716 Issued in CA

Legal business name

LAKE ELSINORE DIAGNOSTICS

Practice address

31569 Canyon Estates Dr Ste 120
Lake Elsinore, CA 92532-0470

Phone

(951) 245-3400

NPI assigned

May 10, 2011

Organization subpart

No

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

Authorized official

Name

Perla I Nunez

Title

Manager

Phone

(951) 245-3400

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1304985600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1304985600000",
    "number": "1114219144",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31569 CANYON ESTATES DR STE 120",
            "city": "LAKE ELSINORE",
            "state": "CA",
            "postal_code": "925320470",
            "telephone_number": "951-245-3400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31569 CANYON ESTATES DR STE 120",
            "city": "LAKE ELSINORE",
            "state": "CA",
            "postal_code": "925320470",
            "telephone_number": "951-245-3400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKE ELSINORE DIAGNOSTICS",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-05-10",
        "last_updated": "2011-05-10",
        "status": "A",
        "authorized_official_last_name": "NUNEZ",
        "authorized_official_first_name": "PERLA",
        "authorized_official_middle_name": "I",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "951-245-3400"
    },
    "taxonomies": [
        {
            "code": "261QR0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology",
            "state": "CA",
            "license": "A73716",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tera Labrosciano, M.A., CCC-SLP
• Debra D Lacy
• Kaleb Can Lai
• Lake Elsinore Clinica Medica Familiar a Medical Corporation
• Lake Elsinore Congregate Care Inc.
• Lake Elsinore Unified School District
• Lake Elsinore Urgent Care Center
• Lakeshore Medical Clinic Inc
• Lakeshore Medical Clinic Inc
• Lakeside Pharmacy

• Radiology Clinic/Center in Lake Elsinore, CA
• Providers in Lake Elsinore, CA by specialty
• Radiology Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2011; 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.