Lakeside Medical Associates, a Medical Group Inc

Primary specialty

Physical TherapistTaxonomy code 225100000X

Legal business name

LAKESIDE MEDICAL ASSOCIATES, A MEDICAL GROUP INC

Doing business as

Lakeside Community Healthcare Medical Group

Practice address

101 S First Street
Suite 1800
Burbank, CA 91502-1938

Phone

(818) 558-7252

Fax

(818) 558-7312

NPI assigned

Aug 1, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Kerry E. Weiner, M.D.

Title

President

Phone

(818) 637-2000

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Lakeside Community Healthcare Medical Group Doing business as

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1154390400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1242000000000",
    "number": "1316953029",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "777 FLOWER ST STE A",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912013000",
            "telephone_number": "818-637-2000",
            "fax_number": "818-242-8761"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 S FIRST STREET",
            "address_2": "SUITE 1800",
            "city": "BURBANK",
            "state": "CA",
            "postal_code": "915021938",
            "telephone_number": "818-558-7252",
            "fax_number": "818-558-7312"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKESIDE MEDICAL ASSOCIATES, A MEDICAL GROUP INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-01",
        "last_updated": "2009-05-11",
        "status": "A",
        "authorized_official_last_name": "WEINER",
        "authorized_official_first_name": "KERRY",
        "authorized_official_middle_name": "E.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "818-637-2000",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GPT001160",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lakeside Community Healthcare Medical Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Roger Chih-Hung Lai, MD
• Vickie Lai
• Bobbi D Laird, ED. S.
• Deborah Lakeman, MA. LMFT
• Lakeside Home Health, Inc.
• Lakeside Medical Associates, a Medical Group, Inc. (Lakeside Community Healthcare Medical Group)
• Lakeside Medical Associates, a Medical Group, Inc. (Lakeside Community Healthcare Medical Group)
• Lakeside Medical Associates, a Medical Group, Inc. (Lakeside Community Healthcare Medical Group)
• Lakeside Medical Associates, a Medical Group, Inc. (Lakeside Community Healthcare Medical Group)
• Lakeside Medical Associates, a Medical Group, Inc. (Lakeside Community Healthcare Medical Group)

• Physical Therapist in Burbank, CA
• Providers in Burbank, CA by specialty
• Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.