Organization
LAKESIDE MEDICAL ASSOICATES, A MEDICAL GROUP, INC.
Active
Other names
Lakeside Community Healthcare Medical Group
Organization subpart
No
Provider details
NPI number
Authorized official
KERRY WEINER M.D. (PRESIDENT)
(818) 637-2000
Entity
Organization
Contact information
Practice address
1135 S SUNSET AVE, SUITE 100, WEST COVINA, CA 91790-3937
(626) 856-2215
(626) 960-2125
Mailing address
777 FLOWER ST STE A, GLENDALE, CA 91201-3000
(818) 637-2000
(818) 242-8761
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
—
—
Other
Enumeration date
10/19/2009
Last updated
10/19/2009
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