NPI Database
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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

NPI Number 1679764229
LBN Legal business name LAKESIDE ORTHOPEDIC INSTITUTE LLC
Authorized official DANIEL HEINER - (PARTNER)
Entity Organization
Organization subpart 1 No
Enumeration date 08/08/2007
Last updated 04/22/2026 - About 1 months ago
Identifiers
AZ Other DF0357 MEDICARE RAILROAD
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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