Individual provider Active NPI

Jean L Lake, M.D.

  • Neurology Physician
  • Long Beach, CA
National Provider Identifier
1386686673
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
G444387 Issued in CA
Practice address
2880 Atlantic Ave
260
Long Beach, CA 90806-1714
Phone
(562) 490-3580
Fax
(562) 490-3584
NPI assigned
Jun 12, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X G444387 CA Primary

Addresses

Primary practice location

2880 Atlantic Ave
260
Long Beach, CA 90806-1714

Mailing address

2880 Atlantic Ave
260
Long Beach, CA 90806-1714
Phone (562) 490-3580

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20111228000248 CA Practitioner - Neurology 2264528728 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
44387CAMDPediatric Dentist
G444387CAMDNeurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Adult & Child Neurology Medical Associates Inc. Neurology CurrentSince Apr 16, 1999 Accepting new patients
UC Regents CurrentSince Jan 5, 2013 Accepting new patients
Los Alamitos Medical Center, Inc. Past Accepting new patients
Torrance Memorial Medical Center Past Accepting new patients
Long Beach Memorial Medical Past Accepting new patients
Dignity Health Past Accepting new patients

Locations

1901 Newport Blvd
Ste 235
Costa Mesa, CA 92627
Phone (562) 490-3580

17360 Brookhurst St
Fountain Vly, CA 92708
Phone (657) 241-3592

2801 Atlantic Ave
Long Beach, CA 90806
Phone (310) 933-2000

2880 Atlantic Ave
Ste 260
Long Beach, CA 90806
Phone (562) 426-3319

File 2939
Los Angeles, CA 90074
Phone (310) 794-6596

10833 Le Conte Ave
Ste 12311
Los Angeles, CA 90095
Phone (310) 825-9124

10833 Le Conte Ave
#12311
Los Angeles, CA 90095
Phone (310) 825-9124

20911 Earl St
Ste 300
Torrance, CA 90503
Phone (310) 370-1200

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1150070400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1386686673",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2880 ATLANTIC AVE",
            "address_2": "260",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908061714",
            "telephone_number": "562-490-3580",
            "fax_number": "562-490-3584"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2880 ATLANTIC AVE",
            "address_2": "260",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908061714",
            "telephone_number": "562-490-3580",
            "fax_number": "562-490-3584"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAKE",
        "first_name": "JEAN",
        "middle_name": "L",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-12",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "CA",
            "license": "G444387",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Long Beach, CA

Sources for this page

Verify at the official NPI Registry.