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Individual

DR. NATALIE J LAKE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
750 N ESTRELLA PKWY STE 40, GOODYEAR, AZ 85338-9279
(623) 889-3477
(623) 889-3478
Mailing address
PO BOX 5204, GOODYEAR, AZ 85338-0603
(623) 889-3477
(623) 889-3478

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
59280
AZ
207Q00000X
Family Medicine Physician
C134094
CA
207Q00000X
Family Medicine Physician
D73655
MD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
441188900
MD
01
606897000
DEPT OF LABOR
01
953BAN97701301
CAREFIRST MARYLAND
01
K6400010
CAREFIRST
01
P01208435
RR MEDICARE
Enumeration date
12/26/2006
Last updated
05/06/2026
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