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Contact Information

LAKESIDE ORTHOPEDIC INSTITUTE LLC
25 RIVIERA BLVD
LAKE HAVASU CITY, AZ86403-5694
 Phone: 928-505-5555
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Orthopaedic Surgery

207X00000X 02 Physician/General Surgery
 

Interventional Pain Medicine

208VP0014X 09 Physician/Interventional Pain Management
 

Magnetic Resonance Imaging Radiologic Technologist

2471M1202X
 

Physical Therapist

225100000X 65 Physical Therapist in Private Practice
Indicates primary specialty

NPI Profile & details for LAKESIDE ORTHOPEDIC INSTITUTE LLC · (Female)

NPI Number 1679764229
Status Active
Credentials
Entity Individual
Enumeration date 08/08/2007
Last updated 04/22/2026 - About 1 months ago
Sole proprietor 1 Not specified
Identifiers
  • AZ Other DF0357 MEDICARE RAILROAD
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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