Organization
LAKESIDE MEDICAL ASSOCIATES A MEDICAL GROUP INC
Active
Other names
Lakeside Community Healthcare Medical Group
Organization subpart
No
Provider details
NPI number
Authorized official
KERRY E. WEINER MD (PRESIDENT)
(818) 637-2000
Entity
Organization
Contact information
Practice address
7325 MEDICAL CENTER DR, SUITE 300, WEST HILLS, CA 91307-1925
(818) 595-3580
(818) 595-3599
Mailing address
777 FLOWER ST STE A, GLENDALE, CA 91201-3000
(818) 637-2000
(818) 242-8761
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
—
—
208800000X
Urology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1184884769
—
CA
Enumeration date
06/17/2008
Last updated
05/06/2009
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