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Organization
LAKE FOREST MEDICAL GROUP, INC.
Active
Organization
LAKE FOREST MEDICAL GROUP, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN C KOUMAS (OWNER)
(949) 770-1950
Entity
Organization
Contact information
Practice address
24401 MUIRLANDS BLVD, SUITE #A, LAKE FOREST, CA 92630-3948
(949) 770-1950
(949) 770-8599
Mailing address
24401 MUIRLANDS BLVD, SUITE #A, LAKE FOREST, CA 92630-3948
(949) 770-1950
(949) 770-8599
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
20A5515
CA
Other
Enumeration date
12/05/2006
Last updated
09/17/2008
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