Gene (Gerald) Eugene Lake, M.D.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

G20748 Issued in AR

Practice address

230 W Laurel St
Unit 703
San Diego, CA 92101-1461

Phone

(619) 595-1564

Fax

(858) 720-8285

NPI assigned

Apr 16, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Gene Lake Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1176681600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1871718528",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "230 W LAUREL ST",
            "address_2": "UNTI 703",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921011461",
            "telephone_number": "619-595-1564",
            "fax_number": "858-720-8285"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "230 W LAUREL ST",
            "address_2": "UNIT 703",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921011461",
            "telephone_number": "619-595-1564",
            "fax_number": "858-720-8285"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAKE",
        "first_name": "GENE (GERALD)",
        "middle_name": "EUGENE",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "AR",
            "license": "G20748",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "GENE",
            "last_name": "LAKE",
            "credential": "M.D.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Neela Lakatoo
• Lake Murray Speech & Language
• Anthony M Lake, RN
• Charissa Lake
• Elizabeth Ann Lake, RD
• Jacob Brody Hood Lake, IDC
• Linda Susan Lake, R.N.
• Menore Gashaw Lake, MD
• Naomi Barrie Lake, SOCIAL WORKER
• Lakhani D.D.S. Inc

• Psychiatry Physician in San Diego, CA
• Providers in San Diego, CA by specialty
• Psychiatry Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.