Provider Demographics
NPI:1407306137
Name:LAKOWSKY & BATLIN MEDICAL CORP
Entity Type:Organization
Organization Name:LAKOWSKY & BATLIN MEDICAL CORP
Other - Org Name:PREMIER MEDICAL CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:ALEXANDER
Authorized Official - Middle Name:
Authorized Official - Last Name:LAKOWSKY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:650-552-8180
Mailing Address - Street 1:1860 EL CAMINO REAL
Mailing Address - Street 2:STE 321
Mailing Address - City:BURLINGAME
Mailing Address - State:CA
Mailing Address - Zip Code:94010-3127
Mailing Address - Country:US
Mailing Address - Phone:650-552-8180
Mailing Address - Fax:650-552-8199
Practice Address - Street 1:1860 EL CAMINO REAL
Practice Address - Street 2:STE 321
Practice Address - City:BURLINGAME
Practice Address - State:CA
Practice Address - Zip Code:94010-3127
Practice Address - Country:US
Practice Address - Phone:650-552-8180
Practice Address - Fax:650-552-8199
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-05
Last Update Date:2016-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA86437261QP2300X
CAA87310261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care