| Lake Forest Medical Group, Inc. | |
|
24401 Muirlands Blvd Suite #a Lake Forest CA 92630-3948 | |
| (949) 770-1950 | |
| (949) 770-8599 |
| Full Name | Lake Forest Medical Group, Inc. |
|---|---|
| Speciality | Family Medicine |
| Location | 24401 Muirlands Blvd, Lake Forest, California |
| Authorized Official Name and Position | John C Koumas (OWNER) |
| Authorized Official Contact | 9497701950 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lake Forest Medical Group, Inc. 24401 Muirlands Blvd Suite #a Lake Forest CA 92630-3948 Ph: (949) 770-1950 | Lake Forest Medical Group, Inc. 24401 Muirlands Blvd Suite #a Lake Forest CA 92630-3948 Ph: (949) 770-1950 |
| NPI Number | 1558429092 |
|---|---|
| Provider Enumeration Date | 12/05/2006 |
| Last Update Date | 09/17/2008 |
| Medicare PECOS PAC ID | 3274594650 |
|---|---|
| Medicare Enrollment ID | O20041019001334 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1558429092 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 20A5515 (California) | Primary |
| Provider Name | John C Koumas |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1134111958 PECOS PAC ID: 4981665379 Enrollment ID: I20041020001393 |
| Provider Name | Mary Koumas |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1306838909 PECOS PAC ID: 2769549310 Enrollment ID: I20090325000724 |
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American Current Care Of California, A Medical Corporation Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 22741 Lambert St Ste 1608, Lake Forest, CA 92630 Phone: 949-581-3011 Fax: 949-581-6457 | |
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Vituity Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 22855 Lake Forest Dr, Suite A, Lake Forest, CA 92630 Phone: 949-770-1023 | |
Camino Health Center Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 22481 Aspan St Ste A, Lake Forest, CA 92630 Phone: 949-240-2030 Fax: 949-429-7627 | |
California Emergency Physicians Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 22855 Lake Forest Dr, # A, Lake Forest, CA 92630 Phone: 949-452-7544 | |
California Functional Internal Medicine Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 22972 El Toro Rd, Lake Forest, CA 92630 Phone: 949-339-5272 |