Organization
LAKESIDE COMMUNITY HEALTHCARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PATRICIA MARTIN (DIRECTOR)
(818) 707-9603
Entity
Organization
Contact information
Practice address
30125 AGOURA RD STE 200, AGOURA HILLS, CA 91301-4322
(818) 707-9603
Mailing address
30125 AGOURA RD STE 200, AGOURA HILLS, CA 91301-4322
(818) 707-9603
Taxonomy
Speciality
Code
Description
License number
State
302R00000X
Health Maintenance Organization
Primary
—
—
Other
Enumeration date
12/30/2008
Last updated
12/30/2008
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