Organization
LAKEWOOD INTERNAL MEDICAL GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LAWRENCE GERSHON M.D. (PRESIDENT)
(562) 633-4117
Entity
Organization
Contact information
Practice address
3650 SOUTH ST, SUITE 110, LAKEWOOD, CA 90712-1502
(562) 633-4117
(562) 633-6560
Mailing address
3650 SOUTH ST, SUITE 110, LAKEWOOD, CA 90712-1502
(562) 633-4117
(562) 633-6560
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
A22752
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
ZZZ70783Z
—
CA
Enumeration date
04/02/2007
Last updated
08/22/2020
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