NPIMap

Organization Active NPI

Lasalle Medical Associates

  • Multi-Specialty Clinic/Center
  • Victorville, CA
National Provider Identifier
1689130098
Registry record updated Aug 21, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X
Legal business name
LASALLE MEDICAL ASSOCIATES
Practice address
14544 7TH St
Victorville, CA 92395-4214
Phone
(760) 245-1025
NPI assigned
Feb 11, 2019
Last updated
Aug 21, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 21, 2020

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

Authorized official

Name
Albert Henry Arteaga, MDNPI 1942398482
Title
Ceo/Owner
Phone
(909) 890-0407

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
Multi-Specialty Clinic/Center 261QM1300X NU Primary

Addresses

Primary practice location

14544 7TH St
Victorville, CA 92395-4214

Mailing address

1855 W Redlands Blvd FL 2
Redlands, CA 92373-3145
Phone (909) 890-0407

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050506000376 CA Part B Supplier - Clinic/Group Practice 1557301744 Receives reassigned benefits from 8 practitioners
4 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Fontana, CA; Hesperia, CA; Rialto, CA; San Bernardino, CA; Victorville, CA

Other NPIs on the same Medicare enrollment 4

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
05D2059781Lasalle Medical Associates14544 7TH St, Victorville, CA 92395Certificate of waiverMay 29, 2027

National Provider Directory

National Provider Directory
Tax ID family
Lasalle Medical Associates7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 1

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": "1549843200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1597968000000",
    "number": "1689130098",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1855 W REDLANDS BLVD FL 2",
            "city": "REDLANDS",
            "state": "CA",
            "postal_code": "923733145",
            "telephone_number": "909-890-0407",
            "fax_number": "909-890-0575"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14544 7TH ST",
            "city": "VICTORVILLE",
            "state": "CA",
            "postal_code": "923954214",
            "telephone_number": "760-245-1025"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LASALLE MEDICAL ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-02-11",
        "last_updated": "2020-08-21",
        "certification_date": "2020-08-21",
        "status": "A",
        "authorized_official_last_name": "ARTEAGA",
        "authorized_official_first_name": "ALBERT",
        "authorized_official_middle_name": "HENRY",
        "authorized_official_title_or_position": "CEO/OWNER",
        "authorized_official_telephone_number": "909-890-0407",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Victorville, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2020; 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.