Individual
DR. JEFFREY PRESTON LAKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
16311 VENTURA BLVD, SUITE 505, ENCINO, CA 91436-2124
(818) 645-5920
Mailing address
16311 VENTURA BLVD, SUITE 505, ENCINO, CA 91436-2124
Taxonomy
Speciality
Code
Description
License number
State
208C00000X
Colon & Rectal Surgery Physician
Primary
A73315
CA
Other
Enumeration date
05/02/2006
Last updated
09/13/2010
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