Organization
LAKESIDE UNION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. KAMRAN AZIMZADEH (DEPUTY SUPERINTENDENT)
(619) 390-2614
Entity
Organization
Contact information
Practice address
12335 WOODSIDE AVE, LAKESIDE, CA 92040-3015
(619) 390-2620
(619) 390-2597
Mailing address
12335 WOODSIDE AVE, LAKESIDE, CA 92040-3015
(619) 390-2620
(619) 390-2597
Taxonomy
Speciality
Code
Description
License number
State
251300000X
Local Education Agency (LEA)
Primary
—
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
SS3768189
—
CA
Enumeration date
08/31/2007
Last updated
08/31/2007
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