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LAKESIDE MEDICAL ASSOCIATES A MEDICAL GROUP INC. NPI 1801051784


NPI Information

NPI: 1801051784
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: 05D1066096

Address:
1500 W WEST COVINA PKWY
WEST COVINA, CA
ZIP 91790
Phone: (626) 430-9991
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LAKESIDE MEDICAL ASSOCIATES, A MEDICAL GROUP, INC. is a family medicine in West Covina, 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 1801051784. 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:

1500 W WEST COVINA PKWY
WEST COVINA, CA
ZIP 91790-708
Phone: (626) 430-9991
Fax: (626) 960-3726

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 05D1066096 - other - urgent care with a certificate type of Certificate of Compliance.

The enumeration date for this NPI number is 7/21/2008 and was last updated on 10/19/2009.


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
1207R00000XInternal MedicineNo
2207VG0400XObstetrics & GynecologyGynecologyNo
3208000000XPediatricsNo
4208600000XSurgeryNo
5207RG0100XInternal MedicineGastroenterologyNo
6207N00000XDermatologyNo
7363A00000XPhysician AssistantNo
8363LX0001XNurse PractitionerObstetrics & GynecologyNo
9363L00000XNurse PractitionerNo
10207Q00000XFamily MedicineYes

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

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