Lake Medical Center, Inc.
NPI 1689863714ActiveOrganization· Psychiatry & Neurology, Neurology· San Marcos, CA
Psychiatry & Neurology, Neurology in San Marcos, California, registered in NPPES in October 2007. The authorized official on file is Michael Shack, M.D., President. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1689863714 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Oct 15, 2007 |
| Last updated in NPPES | Oct 15, 2007 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Psychiatry & Neurology, Neurology Primary | 2084N0400X | G26382 | CA |
| Chiropractor | 111N00000X | DC17617 | CA |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (CA) |
|---|
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