George Blaine Lake, M.D.

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

G86776 Issued in CA

Practice address

100 Willow PLZ
201
Visalia, CA 93291-6206

Phone

(559) 627-9284

Fax

(559) 713-0965

NPI assigned

May 17, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in UT

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Ihc Health Services Inc

  • Multi-Specialty Clinic/Center
  • Sandy, UT
  • NPI 1942325154
  Medicare reassignment NPD
• Obhg Utah LLC

  • Obstetrics & Gynecology Physician
  • Salt Lake City, UT
  • NPI 1457667727
  Medicare reassignment NPD
• Ihc Health Services Inc

  • Family Medicine Physician
  • Tremonton, UT
  • NPI 1487853826
  NPD
• Ihc Health Services, Inc.

  • Psychiatry Physician
  • St George, UT
  • NPI 1023843844
  NPD

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

{
    "created_epoch": "1147824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1380240000000",
    "number": "1194777136",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 WILLOW PLZ",
            "address_2": "201",
            "city": "VISALIA",
            "state": "CA",
            "postal_code": "932916206",
            "telephone_number": "559-627-9284",
            "fax_number": "559-713-0965"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 WILLOW PLZ",
            "address_2": "201",
            "city": "VISALIA",
            "state": "CA",
            "postal_code": "932916206",
            "telephone_number": "559-627-9284",
            "fax_number": "559-713-0965"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAKE",
        "first_name": "GEORGE",
        "middle_name": "BLAINE",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-17",
        "last_updated": "2013-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "CA",
            "license": "G86776",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0067850",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Steven Lacombe, DO
• Ryan James Lad, MD
• Lags Spine & Sportscare Medical Centers Inc
• Lags Spine and Sportscare Medical Centers, Inc.
• Lags Spine and Sportscare Medical Centers, Inc.
• Annie Lakhani
• Sharmeen Hussain Lakhani, LMFT
• Yasmeen Lakhani, O.D.
• Amanda Richards Lakusta, MD
• Gilbert B Lam, DDS

• Obstetrics & Gynecology Physician in Visalia, CA
• Providers in Visalia, CA by specialty
• Obstetrics & Gynecology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.