Lake Avenue Medical Supply Inc.

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

License

53974 Issued in CA

Legal business name

LAKE AVENUE MEDICAL SUPPLY INC.

Practice address

467 N Lake Ave
Pasadena, CA 91101-1215

Phone

(626) 405-0440

Fax

(626) 405-0450

NPI assigned

Nov 15, 2010

Organization subpart

No

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

Authorized official

Name

Mrs. Ronen Sarafian Malek

Title

President

Phone

(626) 405-0440

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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

• Ronen Sarafian

  • Durable Medical Equipment & Medical Supplies
  • Pasadena, CA
  • NPI 1699815696
  NPD (past)

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

{
    "created_epoch": "1289779200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1289779200000",
    "number": "1962703454",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "467 N LAKE AVE",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911011215",
            "telephone_number": "626-405-0440",
            "fax_number": "626-405-0450"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "467 N LAKE AVE",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911011215",
            "telephone_number": "626-405-0440",
            "fax_number": "626-405-0450"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKE AVENUE MEDICAL SUPPLY INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-11-15",
        "last_updated": "2010-11-15",
        "status": "A",
        "authorized_official_last_name": "SARAFIAN MALEK",
        "authorized_official_first_name": "RONEN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "626-405-0440",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "CA",
            "license": "53974",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Peiyu Lai
• Sum Yin Emily Lai
• Yien Liang Lai, L.AC.
• Kendra Ruby Laica
• Lake Avenue Counseling Center
• Lake Community Medical Group, Inc.
• Katrina Lake, L.AC.
• Suzanne Marie Lake, PSY.D.
• Lakeshore Hospice Inc
• Lakeview Dental

• Durable Medical Equipment & Medical Supplies in Pasadena, CA
• Providers in Pasadena, CA by specialty
• Durable Medical Equipment & Medical Supplies in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2010; 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.