Individual
GENE (GERALD) EUGENE LAKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
230 W LAUREL ST, UNIT 703, SAN DIEGO, CA 92101-1461
(619) 595-1564
(858) 720-8285
Mailing address
230 W LAUREL ST, UNTI 703, SAN DIEGO, CA 92101-1461
(619) 595-1564
(858) 720-8285
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
G20748
AR
Other
Enumeration date
04/16/2007
Last updated
07/08/2007
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