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Newly Listed Provider — this NPI profile has been added to the NPI registry within the last 90 days.

LAKESIDE MEDICAL GROUP
NPI 1376448894
Family Medicine in San Antonio De Tlyacapan, JALISCO

Active since October 13, 2026
HIDALGO 148A, SAN ANTONIO DE TLYACAPAN, JALISCO 45922 Get Directions Write a Review

NPPES record added: October 13, 2026. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Lakeside Medical Group NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

LAKESIDE MEDICAL GROUP (NPI 1376448894) is a healthcare organization registered as a family medicine in San Antonio De Tlyacapan, JALISCO and active in the NPI registry since October 2026. The organization lists Javier Ezquerra, Mgr, as its authorized official.

NPPES Registry Identity

NPI1376448894
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameLAKESIDE MEDICAL GROUP
Location AddressHIDALGO 148ASan Antonio De Tlyacapan, JALISCO 45922
Mailing Address5830 E 2nd StCasper, WY 82609-4308 · (801) 896-1181
Organization SubpartNo
Authorized OfficialJavier EzquerraMgr · (801) 896-1181
Enumeration DateOctober 13, 2026
NPPES CertifiedOctober 13, 2026
✔ NPI 1376448894 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Lakeside Medical Group's NPI number?

The NPI number for Lakeside Medical Group is 1376448894. It was assigned to this organization in the NPPES registry on October 13, 2026.

Where is Lakeside Medical Group located?

Lakeside Medical Group is located at Hidalgo 148A, San Antonio De Tlyacapan, JALISCO 45922.

What is Lakeside Medical Group's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

When was this NPI record last updated?

The NPPES record for Lakeside Medical Group was last updated on October 13, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 days ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.