Kenneth B Lake, CRNA
NPI #1003964024 in Fontana, California
Provider Information
- NPI Number
- 1003964024
- Entity Type
- Individual
- Name
- Kenneth B Lake, CRNA
- Gender
- Not Specified
- Sole Proprietor
- No
- Primary Specialty
- Nurse Anesthetist, Certified Registered
- Credential
- CRNA
- Enumeration Date
- Jan 8, 2007
- Last Updated
- Sep 15, 2008
Practice Location
- Address
- 9961 SIERRA AVE
- City
- Fontana
- State
- California
- ZIP Code
- 92335-6720
- Phone
- (909) 427-3910
Specialties & Taxonomy Codes
| Specialty |
|---|
| Nurse Anesthetist, Certified Registered |
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