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 provides Surgery Physician services 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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