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LAKESIDE MEDICAL ASSOCIATES A MEDICAL GROUP INC. NPI 1215973292


NPI Information

NPI: 1215973292
Provider Name: LAKESIDE MEDICAL ASSOCIATES, A MEDICAL GROUP, INC.

Doing Business As: LAKESIDE COMMUNITY HEALTHCARE MEDICAL GROUP

Classification: Family Medicine - 207Q00000X
Entity Type: Organization

CLIA Number: 05D2292977

Address:
14901 RINALDI ST
SUITE 200/201
MISSION HILLS, CA
ZIP 91345
Phone: (818) 365-8553
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LAKESIDE MEDICAL ASSOCIATES, A MEDICAL GROUP, INC. is a family medicine in Mission Hills, CA. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. LAKESIDE MEDICAL ASSOCIATES, A MEDICAL GROUP, INC. NPI is 1215973292. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Lakeside Community Healthcare Medical Group.

The provider's business location address is:

14901 RINALDI ST
SUITE 200/201
MISSION HILLS, CA
ZIP 91345-204
Phone: (818) 365-8553
Fax: (818) 365-4524

The provider's authorized official is Kerry E. Weiner .
The authorized official title is President and has the following contact phone number (818) 637-2000.

The CLIA number assigned to this NPI record is 05D2292977 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 6/20/2006 and was last updated on 5/12/2009.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1213EP1101XPodiatristPrimary Podiatric MedicineNo
2208600000XSurgeryNo
3207N00000XDermatologyNo
4207R00000XInternal MedicineNo
5207RR0500XInternal MedicineRheumatologyNo
6208D00000XGeneral PracticeCALIFORNIANo
7208000000XPediatricsCALIFORNIANo
8363L00000XNurse PractitionerCALIFORNIANo
9207Q00000XFamily MedicineYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1W12279CMEDICARE PINCALIFORNIA
2GR0068383MEDICAIDCALIFORNIA
3W12279MEDICARE PIN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.