NPIMap

Organization Active NPI

Lakeport Emergency Medical Corporation

  • Emergency Medicine Physician
  • Lakeport, CA
National Provider Identifier
1376636597
Registry record updated Jul 7, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
G64122 Issued in CA
Legal business name
LAKEPORT EMERGENCY MEDICAL CORPORATION
Practice address
5176 Hill Rd E
Lakeport, CA 95453-6357
Phone
(626) 447-0296
Fax
(626) 447-6057
NPI assigned
Oct 2, 2006
Last updated
Jul 7, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 7, 2014

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

Authorized official

Name
Steven P. Maron, M.D.NPI 1821026063
Title
President
Phone
(626) 447-0296

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X G64122 CA Primary

Addresses

Primary practice location

5176 Hill Rd E
Lakeport, CA 95453-6357

Mailing address

PO Box 1848
Arcadia, CA 91077-1848
Phone (626) 447-0296

Other identifiers 1

IdentifierTypeStateIssuer
GR0095010MedicaidCA

National Provider Directory

National Provider Directory

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": "1159747200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1404691200000",
    "number": "1376636597",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1848",
            "city": "ARCADIA",
            "state": "CA",
            "postal_code": "910771848",
            "telephone_number": "626-447-0296",
            "fax_number": "626-447-6057"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5176 HILL RD E",
            "city": "LAKEPORT",
            "state": "CA",
            "postal_code": "954536357",
            "telephone_number": "626-447-0296",
            "fax_number": "626-447-6057"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKEPORT EMERGENCY MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-02",
        "last_updated": "2014-07-07",
        "status": "A",
        "authorized_official_last_name": "MARON",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_middle_name": "P.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "626-447-0296",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "G64122",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0095010",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakeport, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2014; 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.