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 12660 Riverside Dr Suite 225, N Hollywood CA 91607-3429. The organization recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Dermatology, Allopathic & Osteopathic Physicians / Family Medicine. Allopathic & Osteopathic Physicians / Dermatology is the primary health care specialty. Lakeside Medical Associates, A Medical Group, Inc. can be contacted via phone (818) 755-0265, or through Weiner, Kerry E. via phone (818) 637-2000.

Contact Information

Primary practice address
12660 Riverside Dr Suite 225 N Hollywood CA 91607-3429
Phone: (818) 755-0265
Fax: (818) 753-9074
Website:
Map and Directions
Authorized official contact:
Name: Weiner, Kerry E. Doctor of Medicine (MD)
Phone: (818) 637-2000

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Dermatology 207N00000X
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X

Profile Details

NPI number 1689869760
LBN Legal business name Lakeside Medical Associates, A Medical Group, Inc.
DBA Doing business as Lakeside Community Healthcare Medical Group
Authorized official Weiner, Kerry E. Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date Sep 11th, 2007
Last updated May 6th, 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 1689869760 NPPES
California MEDICAID GR0068384

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