JON P LAKE

GARDEN GROVE, CA
NPI1295768786
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology
(Licence: CA  A84772)
Additional Taxonomies207ZC0500X Pathology, Cytopathology
(Licence: CA  A84772)
Enumeration Date2006-07-08
Last Update Date2007-07-08
Business Address
-- JON P LAKE MD
12601 GARDEN GROVE BLVD
GARDEN GROVE, CA 92843-1908
Phone number: 714-741-2765
Mailing Address
-- JON P LAKE MD
PO BOX 10076
VAN NUYS, CA 91410-0076
Phone number: 805-578-8300