Lake Harbor Internal Medicine Assoc LLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

M6886 Issued in ID

Legal business name

LAKE HARBOR INTERNAL MEDICINE ASSOC LLC

Practice address

3684 North Harbor Lane
Boise, ID 83703-6914

Phone

(208) 853-4556

Fax

(208) 853-5544

NPI assigned

Feb 5, 2007

Organization subpart

No

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

Authorized official

Name

Keri Erland, MD

Title

Owner Physician

Phone

(208) 853-4556

Specialties & licenses 1

Addresses

Tax ID family

Lake Harbor Internal Medicine2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Lake Harbor Internal Medicine

  • Specialist
  • Boise, ID
  • NPI 1083800015
  NPD tax ID

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

{
    "created_epoch": "1170633600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1851430995",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3684 NORTH HARBOR LANE",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837036914",
            "telephone_number": "208-853-4556",
            "fax_number": "208-853-5544"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3684 NORTH HARBOR LANE",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837036914",
            "telephone_number": "208-853-4556",
            "fax_number": "208-853-5544"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKE HARBOR INTERNAL MEDICINE ASSOC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-05",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ERLAND",
        "authorized_official_first_name": "KERI",
        "authorized_official_title_or_position": "OWNER PHYSICIAN",
        "authorized_official_telephone_number": "208-853-4556",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "ID",
            "license": "M6886",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ryann Lynn Lagomarsino
• Katherine M Laible, PAC
• Lake Harbor Dental
• Lake Harbor Dental PLLC
• Lake Harbor Internal Medicine
• Juliana Lake, LMSW
• Christopher Lakey
• Judy N Lam, PH.D.
• Bryan H Lamb, DMD
• Kirsten F Lamb, NP

• Internal Medicine Physician in Boise, ID
• Providers in Boise, ID by specialty
• Internal Medicine Physician in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.