Lakeside Community Healthcare Medical Group
LBN: Lakeside Medical Associates A Medical Group Inc
Lakeside Community Healthcare Medical Group is an health care organization with primary practice located at 4955 Van Nuys Blvd Suite 308, Sherman Oaks CA 91403-1811. The organization recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Family Medicine, Allopathic & Osteopathic Physicians / Internal Medicine. Allopathic & Osteopathic Physicians / Family Medicine is the primary health care specialty.
Lakeside Medical Associates A Medical Group Inc can be contacted via phone (818) 907-5088, or through Weiner, Kerry E via phone (818) 637-2000.
Contact Information
Primary practice address
4955 Van Nuys Blvd Suite 308
Sherman Oaks CA 91403-1811
Phone: (818) 907-5088
Fax: (818) 907-5891
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | ||
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X |
Profile Details
| NPI number | 1104087774 |
|---|---|
| LBN Legal business name | Lakeside Medical Associates A Medical Group Inc |
| DBA Doing business as | Lakeside Community Healthcare Medical Group |
| Authorized official | Weiner, Kerry E Doctor of Medicine (MD) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Jun 17th, 2008 |
| Last updated | May 6th, 2009 - about 17 years ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1104087774 | NPPES |
| California | MEDICAID | 1104087774 |
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