Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Lakeshore Interventional Treatment Center LLC

Organization Surgery Physician · NPI 1043701543

Lakeshore Interventional Treatment Center LLC is a Surgery Physician in Tempe, Arizona. Licensed in Arizona. Registered with an NPI since 2018.

Licensed in
AZ
In the registry since
2018
Specialties on file
4
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

4765 S Lakeshore Dr
Tempe, AZ 85282
Phone: (480) 566-9755
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Pain Clinic/Center (primary) Taxonomy 261QP3300X
Surgery Physician Taxonomy 208600000X
Ambulatory Surgical Clinic/Center Taxonomy 261QA1903X (AZ)
Multi-Specialty Clinic/Center Taxonomy 261QM1300X

Record details

NPI number1043701543
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Shawn Vigneau — Member · (480) 556-9755
NPI enumeratedMay 21, 2018
Last updated in NPPESFebruary 4, 2019
Mailing address4765 S Lakeshore Dr, Tempe, AZ 85282-7197

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