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 191 S Buena Vista St Suite 150, Burbank CA 91505-4554. The organization recently has 6 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Emergency Medicine, Allopathic & Osteopathic Physicians / Family Medicine, Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Pediatrics, Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner. Allopathic & Osteopathic Physicians / Family Medicine is the primary health care specialty.
Lakeside Medical Associates, A Medical Group, Inc. can be contacted via phone (818) 295-5920, or through Weiner, Kerry E. via phone (818) 637-2000.
Contact Information
Primary practice address
191 S Buena Vista St Suite 150
Burbank CA 91505-4554
Phone: (818) 295-5920
Fax: (818) 295-6965
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Emergency Medicine | 207P00000X | ||
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | ||
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | ||
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | ||
| Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant | 363A00000X | ||
| Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner | 363L00000X |
Profile Details
| NPI number | 1689874596 |
|---|---|
| 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 | Jul 19th, 2007 |
| Last updated | Oct 27th, 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1689874596 | NPPES |
| California | MEDICAID | GR006838A |
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