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LAKESIDE MEDICAL
NPI 1528204922
General Practice in Salt Lake City, UT

Active since January 06, 2009
4701 W 2100 S, BUILDING 3, SALT LAKE CITY, UT 84120(801) 974-3382(801) 974-3295 Get Directions Write a Review

NPPES record last updated: January 7, 2009. Verified against the NPPES registry weekly; last sync: October 04, 2026.

About Lakeside Medical NPPES

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

LAKESIDE MEDICAL (NPI 1528204922) is a healthcare organization registered as a general practice in Salt Lake City, Utah and active in the NPI registry since January 2009. The organization lists Erik Moll, Medical Director, as its authorized official.

NPPES Registry Identity

NPI1528204922
Entity TypeOrganization
Primary Taxonomy208D00000X
Legal Business NameCOMPREHENSIVE FAMILY CLINIC
Location Address4701 W 2100 S, BUILDING 3Salt Lake City, UT 84120-1223
Mailing Address4701 W 2100 S, Building 3Salt Lake City, UT 84120-1223 · (801) 974-3382 · Fax (801) 974-3295
Phone(801) 974-3382
Fax(801) 974-3295
Organization SubpartYesParent: Cr England, Inc
Authorized OfficialErik MollMedical Director · (801) 974-3382
Enumeration DateJanuary 6, 2009
Last NPPES UpdateJanuary 7, 2009
✔ NPI 1528204922 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyGeneral PracticeAllopathic & Osteopathic Physicians
Taxonomy Code208D00000X
License✔ Licensed in UT · 151129-1205
Definition
A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee
Also ListedChiropractorTaxonomy 111N00000X · License 6787397-1202 (UT)
4701 W 2100 S, Salt Lake City, UT 84120
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Other Names 1

Doing Business AsLakeside Medical

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

JONATHAN ROHWER APRN
Nurse Practitioner (Family)
4701 W 2100 S
WEST VALLEY CITY, UT 84120
Salt Lake County (801) 974-3382
DARREN L SORENSEN FNP
Nurse Practitioner (Family)
4701 W 2100 S
SALT LAKE CITY, UT 84120
Salt Lake County (801) 974-3382

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 Comprehensive Family Clinic's NPI number?

The NPI number for Comprehensive Family Clinic is 1528204922. It was assigned to this organization in the NPPES registry on January 6, 2009. The provider is doing business as Lakeside Medical.

Where is Comprehensive Family Clinic located?

Comprehensive Family Clinic is located at 4701 W 2100 S Building 3, Salt Lake City, UT 84120. The listed phone number is (801) 974-3382.

What is Comprehensive Family Clinic's specialty?

The primary specialty registered for this NPI is General Practice with taxonomy code 208D00000X.

When was this NPI record last updated?

The NPPES record for Comprehensive Family Clinic was last updated on January 7, 2009. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 years 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.