Lake Pharmacy

Primary specialty

PharmacistTaxonomy code 183500000X

License

27533 Issued in CA

Legal business name

LAKE PHARMACY

Practice address

287 13TH St
Oakland, CA 94612-3900

Phone

(510) 832-1804

Fax

(510) 891-9278

NPI assigned

Apr 13, 2007

Last updated

Mar 7, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Arnold George Fong, PHARM. D.

Title

Owner

Phone

(510) 832-1804

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

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

{
    "created_epoch": "1176422400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678147200000",
    "number": "1225252836",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "287 13TH ST",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946123900",
            "telephone_number": "510-832-1804",
            "fax_number": "510-891-9278"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "287 13TH ST",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946123900",
            "telephone_number": "510-832-1804",
            "fax_number": "510-891-9278"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKE PHARMACY",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-13",
        "last_updated": "2023-03-07",
        "status": "A",
        "authorized_official_last_name": "FONG",
        "authorized_official_first_name": "ARNOLD",
        "authorized_official_middle_name": "GEORGE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "510-832-1804",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHARM. D."
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CA",
            "license": "27533",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NABP",
            "identifier": "0547426",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHA368610",
            "identifier": "MEDI-CAL",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Martin Lajoie
• Farnoosh Lak, D.M.D.
• Kyle Otto Lakatos
• Lake Merritt Optometry
• Lake Merritt Senior Living LLC (Lake Park Senior Living)
• Gordon Avery Lake, MD
• Lakeview Functional Rehab
• Arathi Lakhole, M.D, M.P.H
• Ashutosh Lal, M.D.
• Nirupama Lal

• Pharmacist in Oakland, CA
• Providers in Oakland, CA by specialty
• Pharmacist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.