Lakeside Community Healthcare Medical Group

LBN: Lakeside Medical Associates A Medical Group, Inc.
Lakeside Community Healthcare Medical Group is an health care organization with primary practice located at 1510 S Central Ave Suite 300, Glendale CA 91204-2500. The organization recently has 4 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Family Medicine, Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Gastroenterology, Allopathic & Osteopathic Physicians / General Practice. Allopathic & Osteopathic Physicians / Family Medicine is the primary health care specialty. Lakeside Medical Associates A Medical Group, Inc. can be contacted via phone (818) 254-1511, or through Weiner, Kerry via phone (818) 637-2000.

Contact Information

Primary practice address
1510 S Central Ave Suite 300 Glendale CA 91204-2500
Phone: (818) 254-1511
Fax: (818) 254-1500
Website:
Map and Directions
Authorized official contact:
Name: Weiner, Kerry Doctor of Medicine (MD)
Phone: (818) 637-2000

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X
Allopathic & Osteopathic Physicians / Gastroenterology 207RG0100X
Allopathic & Osteopathic Physicians / General Practice 208D00000X

Profile Details

NPI number 1205002862
LBN Legal business name Lakeside Medical Associates A Medical Group, Inc.
DBA Doing business as Lakeside Community Healthcare Medical Group
Authorized official Weiner, Kerry Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date May 5th, 2008
Last updated May 11th, 2009 - about 15 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1205002862 NPPES
California MEDICAID 1205002862

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