NPIMap

Organization Active NPI

Lac Medical, Inc

  • Family Medicine Physician
  • Bakersfield, CA
National Provider Identifier
1366992919
Registry record updated Oct 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
G52726 Issued in CA
Legal business name
LAC MEDICAL, INC
Practice address
5300 Lennox Ave Ste 105
Bakersfield, CA 93309-1662
Phone
(661) 735-1710
NPI assigned
Oct 6, 2016
Last updated
Oct 1, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 1, 2024

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

Authorized official

Name
Vipul Raman Dev, MDNPI 1891702122
Title
Owner
Phone
(661) 327-2101

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)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X G52726 CA Primary

Addresses

Primary practice location

5300 Lennox Ave Ste 105
Bakersfield, CA 93309-1662

Mailing address

2901 Sillect Ave Ste 201
Bakersfield, CA 93308-6373
Phone (661) 327-2101

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170118000835 CA Part B Supplier - Clinic/Group Practice 5294017703 Receives reassigned benefits from 9 practitioners
Practice locations: Bakersfield, CA

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

  • Vipmd
    • Interventional Cardiology Physician
    • Bakersfield, CA
    • NPI 1124521018

    Member Of

    NPD member

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/GDAHAD

Practitioners & affiliated clinicians

Practitioners 10

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1475712000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1727740800000",
    "number": "1366992919",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2901 SILLECT AVE STE 201",
            "city": "BAKERSFIELD",
            "state": "CA",
            "postal_code": "933086373",
            "telephone_number": "661-327-2101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5300 LENNOX AVE STE 105",
            "city": "BAKERSFIELD",
            "state": "CA",
            "postal_code": "933091662",
            "telephone_number": "661-735-1710"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAC MEDICAL, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-10-06",
        "last_updated": "2024-10-01",
        "certification_date": "2024-10-01",
        "status": "A",
        "authorized_official_last_name": "DEV",
        "authorized_official_first_name": "VIPUL",
        "authorized_official_middle_name": "RAMAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "661-327-2101",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "G52726",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bakersfield, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2024; 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.

Verify at the official NPI Registry.