Lakeside Medical Associates, a Medical Group, Inc.

Primary specialty

Urology PhysicianTaxonomy code 208800000X

Legal business name

LAKESIDE MEDICAL ASSOCIATES, A MEDICAL GROUP, INC.

Practice address

18350 Roscoe Blvd
Suite 307
Northridge, CA 91325-4109

Phone

(818) 886-3100

Fax

(818) 718-0164

NPI assigned

Jun 16, 2007

Organization subpart

No

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

Authorized official

Name

Kerry E. Weiner, M.D.

Title

President

Phone

(818) 637-2000

Specialties & licenses 1

Addresses

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": "1181952000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1242086400000",
    "number": "1477758803",
    "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": "18350 ROSCOE BLVD",
            "address_2": "SUITE 307",
            "city": "NORTHRIDGE",
            "state": "CA",
            "postal_code": "913254109",
            "telephone_number": "818-886-3100",
            "fax_number": "818-718-0164"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKESIDE MEDICAL ASSOCIATES, A MEDICAL GROUP, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-16",
        "last_updated": "2009-05-12",
        "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_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Urology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lakeside Community Healthcare Medical Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Barbara Jean Lack, DDS
• Madeleine Marie Lafia, MFT
• Thomas Gene Lagatta, D.D.S.
• Kayla Laguilles
• Kim Lai, O.D.
• Marufa Farooque Lala
• Raymond Lam, M.D.
• Stephanie Lam, BA
• Elizabeth Mairla Landaverde, NURSE PRACTITIONER
• Ederlina Pecson Landeta, MN, FNP

• Urology Physician in Northridge, CA
• Providers in Northridge, CA by specialty
• Urology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 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.