Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1548721244 Individual Practitioner Male Practitioner

Dr. Nicolas Lara , MD

General Practice • Beale Afb, CA

Professional Overview & Biography Verified Profile Summary

Dr. Nicolas Lara, MD is a registered healthcare professional specializing in General Practice in Beale Afb, CA. Practice services are available at 15301 WARREN SHINGLE RD under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

15301 Warren Shingle Rd

Beale Afb, CA 959031905

Telephone 5306342941
Associated Practice Facility / Clinic
🏢 9th Medgrp-Beale Facility NPI 1184695991

Specialty Benchmarks & Practice Insights

Comparative analytics for General Practice in Beale Afb, CA

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 31.1 Yrs
Regional Practice Density
4 Specialists

Practicing in Beale Afb, CA (2300 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

CMS Verified: 2020-08-09
General Practice Primary Specialty

NUCC Taxonomy Code: 208D00000X

State License IN 01084450A

A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions.

Internal Medicine

NUCC Taxonomy Code: 207R00000X

State License IL 125.074068

A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

10 Associated Practitioners
Jayden Montejano , RD

Dietitian, Registered

NPI 1093583916

Registered Dietitian

NPI 1134867732

Doctor of Dental Medicine

NPI 1194414938

Doctor of Dental Medicine

Dr. Meredith Studer , DPT

Physical Therapist

NPI 1336652205

Doctor of Physical Therapy

Dr. Travis Lyon , DO

Family Medicine

NPI 1417450750

Doctor of Osteopathic Medicine (D.O.)

NPI 1437807039

Doctor of Osteopathic Medicine (D.O.)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

16 Historical Events
📍
Updated Practice Location June 19, 2020

Registered at 15301 WARREN SHINGLE RD, BEALE AFB, CA 959031905 (Tel: 5306342941)

📍
Updated Business Mailing Address June 19, 2020

Registered at 15301 WARREN SHINGLE RD, BEALE AFB, CA 959031905

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) August 29, 2019

Internal Medicine (License #125.074068 in IL)

📍
Updated Practice Location June 12, 2019

Registered at 3249 OAK PARK AVE, BERWYN, IL 604020715 (Tel: 7087836566)

📍
Updated Business Mailing Address June 12, 2019

Registered at 3249 OAK PARK AVE, BERWYN, IL 604020715 (Tel: 7087833401)

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) June 12, 2019

Military Health Care Provider (License #125.074068 in IL)

📍
Updated Practice Location June 10, 2019

Registered at 2160 S 1ST AVE, MAYWOOD, IL 601533328 (Tel: 7087836566)

📍
Updated Business Mailing Address June 10, 2019

Registered at 2160 S 1ST AVE, MAYWOOD, IL 601533328 (Tel: 7087833401)

👤
Provider Name / Credentials Updated June 10, 2019

Recorded as NICOLAS LARA, MD

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) June 10, 2019

Student in an Organized Health Care Education/Training Program (License #125.074068 in IL)

NPI Profile Active March 29, 2019

NPI status registered as active in NPPES database

📍
Updated Practice Location March 29, 2019

Registered at 3722 HARLEM AVE STE LL34, RIVERSIDE, IL 605462320 (Tel: 7087836566)

📍
Updated Business Mailing Address March 29, 2019

Registered at 3249 OAK PARK AVE, BERWYN, IL 604023429 (Tel: 7087833401)

👤
Provider Name / Credentials Updated March 29, 2019

Recorded as NICOLAS LARA

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) March 29, 2019

Student in an Organized Health Care Education/Training Program

🟢
Initial NPI Registration & Enumeration March 26, 2019

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1548721244
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: March 26, 2019
Last Update: August 09, 2020
Sole Proprietor: No

Mailing Address

15301 Warren Shingle Rd

Beale Afb, CA 959031905

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.