# LAKESIDE MEDICAL ASSOCIATES, A MEDICAL GROUP, INC.

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

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

## Provider details

- **NPI number:** 1962667857
- **Authorized official:** KERRY E. WEINER M.D. (PRESIDENT)
- **Authorized official phone:** (818) 637-2000

## Contact information

- **Practice address:** 191 S BUENA VISTA ST, SUITE 440, BURBANK, CA 91505-4504
- **Practice address phone:** (818) 848-3763
- **Practice address fax:** (818) 848-3785
- **Mailing address:** 777 FLOWER STREET, SUITE A, GLENDALE, CA 91201-3000
- **Mailing address phone:** (818) 637-2000
- **Mailing address fax:** (818) 242-8761

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207V00000X | Obstetrics & Gynecology Physician | — | NULL | Yes |
| 207V00000X | Obstetrics & Gynecology Physician | — | — | Yes |

## Other

- **Enumeration date:** 07/21/2008
- **Last updated:** 05/11/2009