LAKESIDE MEDICAL ASSOCIATES A MEDICAL GROUP INC. NPI 1043256027

NPI Information

NPI: 1043256027
Provider Name: LAKESIDE MEDICAL ASSOCIATES, A MEDICAL GROUP, INC.

Doing Business As: LAKESIDE COMMUNITY HEALTHCARE MEDICAL GROUP

Classification: Family Medicine - 207Q00000X
Entity Type: Organization

Address:
607 S GLENOAKS BLVD
BURBANK, CA
ZIP 91502
Phone: (818) 557-2671
Get Directions

LAKESIDE MEDICAL ASSOCIATES, A MEDICAL GROUP, INC. is a family medicine in Burbank, 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 1043256027. 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:

607 S GLENOAKS BLVD
BURBANK, CA
ZIP 91502-424
Phone: (818) 557-2671
Fax: (818) 557-0761

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 05D1072811 - 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 Code	Taxonomy Clasification	Taxonomy Specialization	License State	Primary
1	363L00000X	Nurse Practitioner		CALIFORNIA	No
2	207R00000X	Internal Medicine			No
3	207RR0500X	Internal Medicine	Rheumatology		No
4	208000000X	Pediatrics			No
5	207Q00000X	Family Medicine			Yes

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 Identifier	Other Provider Identifier Type	Other Provider Identifier State
1	W12279B	MEDICARE PIN	CALIFORNIA
2	W12279	MEDICARE PIN
3	GR0068382	MEDICAID	CALIFORNIA

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

NPI Synchronization or Removal

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.

« Previous NPI

Next NPI »