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Organization
LAKESIDE MEDICAL ORGANIZATION, A MEDICAL GROUP INC.
Active
Organization
LAKESIDE MEDICAL ORGANIZATION, A MEDICAL GROUP INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JESSICA ARCE-GOMEZ (CREDENTIALING SUPERVISOR)
(818) 654-3400
Entity
Organization
Contact information
Practice address
8501 FALLBROOK AVE STE 300, WEST HILLS, CA 91304-3269
(818) 654-3400
(818) 933-0525
Mailing address
8501 FALLBROOK AVE STE 300, WEST HILLS, CA 91304-3269
(818) 654-3400
(818) 933-0525
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
—
—
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
Primary
—
—
207RC0000X
Cardiovascular Disease Physician
—
—
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
—
—
207RG0100X
Gastroenterology Physician
—
—
207RR0500X
Rheumatology Physician
—
—
207V00000X
Obstetrics & Gynecology Physician
—
—
208000000X
Pediatrics Physician
—
—
208100000X
Physical Medicine & Rehabilitation Physician
—
—
2085B0100X
Body Imaging Physician
—
—
208600000X
Surgery Physician
—
—
208800000X
Urology Physician
—
—
213E00000X
Podiatrist
—
—
261QU0200X
Urgent Care Clinic/Center
—
—
Other
Enumeration date
11/16/2009
Last updated
09/03/2026
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