LAGS SPINE AND SPORTSCARE MEDICAL CENTERS, INC. (NPI# 1083175483) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1083175483 |
| Entity Type | Organization |
| Organization Name | LAGS SPINE AND SPORTSCARE MEDICAL CENTERS, INC. |
| Practice Address |
777 S Ham Ln Ste G Lodi CA 95242-3593 |
| Mailing Address |
218 N I St Lompoc CA 93436-0909 |
| Practice Telephone | 8057367886 |
| Mailing Telephone | 8057367886 |
| Enumeration Date | 2019-03-28 |
| Last Update Date | 2019-03-28 |
| Authorized Official Name | HALLIE MEDINA (CONTRACTING ASSISTANT) |
| Authorized Official Telephone | 6614321451 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2081P2900X |
Physical Medicine & Rehabilitation Specialization: Pain Medicine |
Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Lags Medical Center | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912460874 | Lags Spine and Sportscare Medical Centers, Inc. | Physical Medicine & Rehabilitation | 5701 21st Ave W Ste 3, Bradenton, FL 34209-5605 | 2019-04-08 |
| 1174084578 | Lags Spine and Sportscare Medical Centers, Inc. | Physical Medicine & Rehabilitation | 802 Iowa Ave, Los Banos, CA 93635-3450 | 2019-03-28 |
| 1275090870 | Lags Spine and Sportscare Medical Centers, Inc. | Social Worker | 2651 S C St Ste 200, Oxnard, CA 93033-3560 | 2019-03-01 |
| 1346707114 | Lags Spine and Sportscare Medical Centers, Inc. | Social Worker | 607 Creston Rd, Paso Robles, CA 93446-2775 | 2019-02-27 |
| 1790249894 | Lags Spine and Sportscare Medical Centers, Inc. | Psychologist | 3751 E Shields Avenue, Fresno, CA 93726 | 2019-01-23 |
| 1700357068 | Lags Spine and Sportscare Medical Centers, Inc. | Durable Medical Equipment & Medical Supplies | 3550 Q St Ste 105, Bakersfield, CA 93301-1645 | 2018-12-16 |
| 1487122339 | Lags Spine and Sportscare Medical Centers, Inc. | Physical Medicine & Rehabilitation | 11820 Ne Crestwood Dr Ste 100, Vancouver, WA 98684-5103 | 2018-11-08 |
| 1689157059 | Lags Spine and Sportscare Medical Centers, Inc. | Physical Medicine & Rehabilitation | 801 E Chapel St Ste 6, Santa Maria, CA 93454-4607 | 2018-09-12 |
| 1588147094 | Lags Spine and Sportscare Medical Centers, Inc. | Physical Medicine & Rehabilitation | 803 Coffee Rd Ste 11, Modesto, CA 95355-4244 | 2018-09-11 |
| 1992288401 | Lags Spine and Sportscare Medical Centers, Inc. | Physical Medicine & Rehabilitation | 1050 Las Tablas Rd Ste 16, Templeton, CA 93465-9480 | 2018-09-11 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Oregon Corporations, Companies and Business Names | LAGS SPINE AND SPORTSCARE MEDICAL CENTERS, INC | 218 North I Street, Lompoc, CA 93436 |
| Washington State Corporations | LAGS SPINE AND SPORTSCARE MEDICAL CENTERS, INC. | 11820 Ne Crestwood Dr, Vancouver, WA 98684-5102 |
| Street Address |
777 S HAM LN STE G |
| City | LODI |
| State | CA |
| Zip Code | 95242-3593 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285125807 | Victoria Galvez | Psychologist | 1103 Tudor St, Lodi, CA 95242 | 2018-05-21 |
| 1174931471 | Shuk Mei Chung | Physician Assistant | 2122 W Kettleman Ln, Lodi, CA 95242 | 2014-07-30 |
| 1275962169 | Sharon Elizabeth Palmer | Speech-Language Pathologist | 1200 W Tokay St, Lodi, CA 95242 | 2013-11-01 |
| 1114286093 | Brandee Lyn Smith | Speech-Language Pathologist | 1547 Lexington Dr, Lodi, CA 95242 | 2012-05-11 |
| 1255609509 | Jennifer Marie Wallmark | Speech-Language Pathologist | 8 S. Cambridge Dr., Lodi, CA 95242 | 2011-12-01 |
| 1649459546 | Kimberly Ann White | Counselor | 441 S. Ham Lane Suite A, Lodi, CA 95242 | 2007-10-26 |
| 1255541991 | Heather Baldauff | Occupational Therapist | 800 South Lower Sacramento Road, Lodi Memorial Hospital West, Lodi, CA 95242 | 2007-05-23 |
| 1730227182 | Clifford John Bradshaw | Dentist | 801 S Ham Lane, Suite D, Lodi, CA 95242 | 2007-02-01 |
| 1861541799 | Catherine Ann Gravish | Physical Therapist | 800 South Ham Lane, Lodi, CA 95242 | 2007-01-09 |
| 1497814511 | Stewart Chiropractic Corp | Chiropractor | 1420 W Kettleman Ln #k-1, Lodi, CA 95242 | 2006-12-06 |
| Find all providers in zip 95242 | ||||
| Taxonomy Code | 2081P2900X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Physical Medicine & Rehabilitation |
| Specialization | Pain Medicine |
| A physician who provides a high level of care, either as a primary physician or consultant, for patients experiencing problems with acute, chronic or cancer pain in both hospital and ambulatory settings. Patient care needs may also be coordinated with other specialists. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition changed, source changed] Additional Resources: American Board of Physical Medicine and Rehabilitation, 2007. http://www.abpmr.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Physical Medicine and Rehabilitation. A subspecialty certificate was approved by the ABMS in 1999. ACGME Accredited Residency Program Requirements: Proposal under development. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881295608 | San Diego Comprehensive Pain Management Center, Inc | Physical Medicine & Rehabilitation | 1575 W Main St, El Centro, CA 92243-2211 | 2020-11-06 |
| 1760013536 | Aveva Medical Aesthetics Inc. | Physical Medicine & Rehabilitation | 4702 W 1st St Ste C, Santa Ana, CA 92703-3100 | 2020-01-30 |
| 1902445620 | Irina L Melnik, Md Professional Corporation | Physical Medicine & Rehabilitation | 655 Redwood Hwy Frontage Rd Ste 203, Mill Valley, CA 94941-3025 | 2019-12-27 |
| 1124669544 | Algos Inc., A Medical Corporation | Physical Medicine & Rehabilitation | 26357 Mcbean Pkwy Ste 210, Santa Clarita, CA 91355-4497 | 2019-10-07 |
| 1174084578 | Lags Spine and Sportscare Medical Centers, Inc. | Physical Medicine & Rehabilitation | 802 Iowa Ave, Los Banos, CA 93635-3450 | 2019-03-28 |
| 1679031611 | Jesus H. Lao Md Inc | Physical Medicine & Rehabilitation | 6699 Alvarado Rd Ste 2304, San Diego, CA 92120-5241 | 2019-03-08 |
| 1316404262 | Advanced Pain Diagnostic & Solutions, Inc. | Physical Medicine & Rehabilitation | 1921 Sycamore Ln, Davis, CA 95616-0844 | 2019-02-27 |
| 1689157059 | Lags Spine and Sportscare Medical Centers, Inc. | Physical Medicine & Rehabilitation | 801 E Chapel St Ste 6, Santa Maria, CA 93454-4607 | 2018-09-12 |
| 1588147094 | Lags Spine and Sportscare Medical Centers, Inc. | Physical Medicine & Rehabilitation | 803 Coffee Rd Ste 11, Modesto, CA 95355-4244 | 2018-09-11 |
| 1992288401 | Lags Spine and Sportscare Medical Centers, Inc. | Physical Medicine & Rehabilitation | 1050 Las Tablas Rd Ste 16, Templeton, CA 93465-9480 | 2018-09-11 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.