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LAKE FOREST MEDICAL GROUP, INC.
NPI 1558429092
Family Medicine in Lake Forest, CA

Active since December 05, 2006CLIA 05D0717353 · Microscopy
24401 MUIRLANDS BLVD, SUITE #A, LAKE FOREST, CA 92630(949) 770-1950(949) 770-8599 Get Directions Write a Review

NPPES record last updated: September 17, 2008. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Lake Forest Medical Group, Inc. NPPES

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

LAKE FOREST MEDICAL GROUP, INC. (NPI 1558429092) is a healthcare organization registered as a family medicine in Lake Forest, California and active in the NPI registry since December 2006. The organization holds a CLIA Microscopy certificate valid through December 24, 2027 and lists John C Koumas, Owner, as its authorized official.

NPPES Registry Identity

NPI1558429092
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameLAKE FOREST MEDICAL GROUP, INC.
Location Address24401 MUIRLANDS BLVD, SUITE #ALake Forest, CA 92630-3948
Mailing Address24401 Muirlands Blvd, Suite #aLake Forest, CA 92630-3948 · (949) 770-1950 · Fax (949) 770-8599
Phone(949) 770-1950
Fax(949) 770-8599
Organization SubpartNo
Authorized OfficialJohn C KoumasOwner · (949) 770-1950
Enumeration DateDecember 5, 2006
Last NPPES UpdateSeptember 17, 2008
✔ NPI 1558429092 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in CA · 20A5515
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.
24401 MUIRLANDS BLVD, Lake Forest, CA 92630
Open in Google Maps ↗

Other Identifiers 2

Medicare UPINC64510CA
Medicare UPINE97960CA

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate for Provider-Performed Microscopy Procedures (PPMP) 05D0717353

Lake Forest Med Group Inc · Lake Forest, CA
Active · expires Dec 24, 2027
CLIA Number05D0717353
Laboratory TypePhysician Office
Certificate Effective DateDecember 25, 2025
Certificate Expiration DateDecember 24, 2027
Laboratory DirectorThomas Koumas
Laboratory Phone(949) 770-1950
Laboratory LocationLake Forest Med Group Inc24401 Muirlands Blvd Suite A, Lake Forest, CA 92630
CLIA data matches this NPI record on: Address Phone
This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.

Other Providers at the Same Location NPPES 3

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

PAULA WILSON HAMBLETON
Dentist (General Practice)
24401 MUIRLANDS BLVD, SUITE D
LAKE FOREST, CA 92630
Orange County (714) 586-6114
DR. MARY M KOUMAS D.O.
Family Medicine
24401 MUIRLANDS BLVD, SUITE #A
LAKE FOREST, CA 92630
Orange County (949) 770-1950
KATHY MORTAZAVI DDS
Dentist
24401 MUIRLANDS BLVD
LAKE FOREST, CA 92630
Orange County (949) 257-5152

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 Lake Forest Medical Group, Inc.'s NPI number?

The NPI number for Lake Forest Medical Group, Inc. is 1558429092. It was assigned to this organization in the NPPES registry on December 5, 2006.

Where is Lake Forest Medical Group, Inc. located?

Lake Forest Medical Group, Inc. is located at 24401 Muirlands Blvd Suite #a, Lake Forest, CA 92630. The listed phone number is (949) 770-1950.

What is Lake Forest Medical Group, Inc.'s specialty?

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

Does Lake Forest Medical Group, Inc. hold a CLIA laboratory certificate?

Yes. A Certificate for Provider-Performed Microscopy Procedures (PPMP) (number 05D0717353) is associated with this NPI, valid through December 24, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Lake Forest Medical Group, Inc. was last updated on September 17, 2008. 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.