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Organization
LAKE COMMUNITY MEDICAL GROUP, INC.
Active
Organization
LAKE COMMUNITY MEDICAL GROUP, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STEPHEN M LEVINE MD (PRESIDENT)
(626) 405-0449
Entity
Organization
Contact information
Practice address
596 N LAKE AVE, SUITE 201, PASADENA, CA 91101-1455
(626) 405-0449
(626) 405-0439
Mailing address
596 N LAKE AVE, SUITE 201, PASADENA, CA 91101-1455
(626) 405-0449
(626) 405-0439
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
07/07/2011
Last updated
07/07/2011
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