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LAKESIDE MEDICAL ASSOCIATES A MEDICAL GROUP INC NPI 1184884769


NPI Information

NPI: 1184884769
Provider Name: LAKESIDE MEDICAL ASSOCIATES A MEDICAL GROUP INC

Doing Business As: LAKESIDE COMMUNITY HEALTHCARE MEDICAL GROUP

Classification: Urology - 208800000X
Entity Type: Organization

CLIA Number: 05D1078346

Address:
7325 MEDICAL CENTER DR
SUITE 300
WEST HILLS, CA
ZIP 91307
Phone: (818) 595-3580
Get Directions

LAKESIDE MEDICAL ASSOCIATES A MEDICAL GROUP INC is an urology in West Hills, CA. The provider is a urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures. LAKESIDE MEDICAL ASSOCIATES A MEDICAL GROUP INC NPI is 1184884769. 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:

7325 MEDICAL CENTER DR
SUITE 300
WEST HILLS, CA
ZIP 91307-925
Phone: (818) 595-3580
Fax: (818) 595-3599

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 05D1078346 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 6/17/2008 and was last updated on 5/6/2009.


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
1207RC0000XInternal MedicineCardiovascular DiseaseNo
2208800000XUrologyYes

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
11184884769MEDICAIDCALIFORNIA
2W12279MEDICARE PINCALIFORNIA

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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