Lake, George Blaine
Lake, George Blaine is an sole proprietor health care provider with primary practice located at 100 Willow Plz 201, Visalia CA 93291-6206. He recently has only one registered license in Allopathic & Osteopathic Physicians / Obstetrics & Gynecology, which is considered as his primary health care specialty. Lake, George Blaine can be contacted via phone (559) 627-9284.Contact Information
Primary practice address
100 Willow Plz 201
Visalia CA 93291-6206
Phone: (559) 627-9284
Fax: (559) 713-0965
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Obstetrics & Gynecology | 207V00000X | G86776 | California |
Profile Details
| NPI number | 1194777136 |
|---|---|
| LBN Legal business name | Lake, George Blaine |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | May 17th, 2006 |
| Last updated | Sep 27th, 2013 - about 12 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1194777136 | NPPES |
| California | MEDICAID | GR0067850 |
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