Lakeview Imaging LLC

Primary specialty

Physiological LaboratoryTaxonomy code 293D00000X

Legal business name

LAKEVIEW IMAGING LLC

Practice address

39546 Cline Miller PL
Fawnskin, CA 92333

Phone

(909) 366-0779

NPI assigned

Jan 6, 2015

Last updated

Jan 6, 2015By 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

Dean Powell

Title

Owner

Phone

(909) 366-0779

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1420502400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1420502400000",
    "number": "1609264175",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 346",
            "city": "FAWNSKIN",
            "state": "CA",
            "postal_code": "923330346"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "39546 CLINE MILLER PL",
            "city": "FAWNSKIN",
            "state": "CA",
            "postal_code": "92333",
            "telephone_number": "909-366-0779"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKEVIEW IMAGING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-01-06",
        "last_updated": "2015-01-06",
        "status": "A",
        "authorized_official_last_name": "POWELL",
        "authorized_official_first_name": "DEAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "909-366-0779"
    },
    "taxonomies": [
        {
            "code": "293D00000X",
            "taxonomy_group": "",
            "desc": "Physiological Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2015; 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.