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 M.D. (PRESIDENT)
(818) 637-2000
Entity
Organization
Contact information
Practice address
18350 ROSCOE BLVD, SUITE 307, NORTHRIDGE, CA 91325-4109
(818) 886-3100
(818) 718-0164
Mailing address
777 FLOWER ST STE A, GLENDALE, CA 91201-3000
(818) 637-2000
(818) 242-8761
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
—
—
Other
Enumeration date
06/16/2007
Last updated
05/12/2009
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