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LAKESIDE MEDICAL ASSOCIATES A MEDICAL GROUP INC. NPI 1538323993


NPI Information

NPI: 1538323993
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: 05D0674880

Address:
612 E JANSS RD
THOUSAND OAKS, CA
ZIP 91360
Phone: (805) 373-0725
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LAKESIDE MEDICAL ASSOCIATES, A MEDICAL GROUP, INC. is a family medicine in Thousand Oaks, 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 1538323993. 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:

612 E JANSS RD
THOUSAND OAKS, CA
ZIP 91360-113
Phone: (805) 373-0725
Fax: (805) 373-0574

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 05D0674880 - physician office with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 7/15/2008 and was last updated on 9/4/2009.


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
2363L00000XNurse PractitionerNo
3208000000XPediatricsNo
4207Q00000XFamily 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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