# LAKESIDE MEDICAL ASSOCIATES, A MEDICAL GROUP, INC.

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Lakeside Community Healthcare Medical Group
- **Organization subpart:** No

## Provider details

- **NPI number:** 1659576072
- **Authorized official:** KERRY E. WEINER M.D. (PRESIDENT)
- **Authorized official phone:** (818) 637-2000

## Contact information

- **Practice address:** 1500 S CENTRAL AVE, SUITE 326, GLENDALE, CA 91204-2530
- **Practice address phone:** (818) 956-8582
- **Practice address fax:** (818) 956-0329
- **Mailing address:** 777 FLOWER ST STE A, GLENDALE, CA 91201-3000
- **Mailing address phone:** (818) 637-2000
- **Mailing address fax:** (818) 242-8761

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207RE0101X | Endocrinology, Diabetes & Metabolism Physician | — | NULL | Yes |
| 207RE0101X | Endocrinology, Diabetes & Metabolism Physician | — | — | Yes |

## Other

- **Enumeration date:** 06/16/2007
- **Last updated:** 05/11/2009