Lake Forest Medical Group, Inc.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

20A5515 Issued in CA

Legal business name

LAKE FOREST MEDICAL GROUP, INC.

Practice address

24401 Muirlands Blvd
Suite #a
Lake Forest, CA 92630-3948

Phone

(949) 770-1950

Fax

(949) 770-8599

NPI assigned

Dec 5, 2006

Organization subpart

No

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

Authorized official

Name

Dr. John C KoumasNPI 1134111958

Title

Owner

Phone

(949) 770-1950

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPDPlans: Blue Shield 65 Plus (HMO) (H0504-015-000, H0504); Blue Shield 65 Plus (HMO) (H0504-039-000, H0504); Blue Shield 65 Plus Plan 2 (HMO) (H0504-021-000, H0504); Blue Shield Inspire (HMO) (H0504-041-000, H0504); Blue Shield 65 Plus (HMO) (H0504-038-000, H0504); Blue Shield Inspire (HMO) (H0504-047-000, H0504); Blue Shield 65 Plus (HMO) (H0504-026-000, H0504); Blue Shield Advantage (HMO) (H0504-050-000, H0504); Blue Shield AdvantageOptimum Plan (HMO) (H5928-004-000, H5928); Blue Shield Inspire (HMO) (H0504-043-000, H0504)…

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• John C Koumas, D.O.

  • Family Medicine Physician
  • West Covina, CA
  • NPI 1134111958
  Medicare reassignment Care Compare group NPD Authorized official
• Mary M Koumas, D.O.

  • Family Medicine Physician
  • Lake Forest, CA
  • NPI 1306838909
  Medicare reassignment Care Compare group NPD
• Tamara Ledford Cordia, PA-C

  • Physician Assistant
  • Newport Beach, CA
  • NPI 1215185921
  Medicare reassignment
• Oana-Diana Popescu, PA

  • Physician Assistant
  • Lake Forest, CA
  • NPI 1083133250
  Medicare reassignment
• Patricia Breen-McDonough

  • Physician Assistant
  • West Covina, CA
  • NPI 1861484685
  NPD (past)

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

{
    "created_epoch": "1165276800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1221609600000",
    "number": "1558429092",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24401 MUIRLANDS BLVD",
            "address_2": "SUITE #A",
            "city": "LAKE FOREST",
            "state": "CA",
            "postal_code": "926303948",
            "telephone_number": "949-770-1950",
            "fax_number": "949-770-8599"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24401 MUIRLANDS BLVD",
            "address_2": "SUITE #A",
            "city": "LAKE FOREST",
            "state": "CA",
            "postal_code": "926303948",
            "telephone_number": "949-770-1950",
            "fax_number": "949-770-8599"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKE FOREST MEDICAL GROUP, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-05",
        "last_updated": "2008-09-17",
        "status": "A",
        "authorized_official_last_name": "KOUMAS",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "949-770-1950",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "20A5515",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jin Kuo, RDN
• Jonathan La, PHARMD
• Lake Forest Acupuncture Clinic
• Lake Forest Home Care, Inc.
• Lake Forest Hospice
• Lake Forest Pharmacy LLC
• Lake Forest Post Acute LLC
• Lake Forest Residential Care Facility Inc.
• Elizabeth Lakin
• Diemquyen Lam, PHARM D

• Family Medicine Physician in Lake Forest, CA
• Providers in Lake Forest, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.