Lakeside Medical Associates, a Medical Group, Inc.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

LAKESIDE MEDICAL ASSOCIATES, A MEDICAL GROUP, INC.

Doing business as

Lakeside Community Healthcare Medical Group

Practice address

191 S Buena Vista St
2ND Floor
Burbank, CA 91505-4504

Phone

(818) 524-2003

Fax

(818) 524-2807

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.NPI 1528062437

Title

President

Phone

(818) 637-2000

Specialties & licenses 5

Addresses

Other identifiers 1

Other names 1

• Lakeside Community Healthcare Medical Group Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Kerry E Weiner, M.D.

  • Gastroenterology Physician
  • Burbank, CA
  • NPI 1528062437
  Authorized official Same address or phone

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

{
    "created_epoch": "1181952000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1242000000000",
    "number": "1649475070",
    "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": "191 S BUENA VISTA ST",
            "address_2": "2ND FLOOR",
            "city": "BURBANK",
            "state": "CA",
            "postal_code": "915054504",
            "telephone_number": "818-524-2003",
            "fax_number": "818-524-2807"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKESIDE MEDICAL ASSOCIATES, A MEDICAL GROUP, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-16",
        "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_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RE0101X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208800000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Urology",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1649475070",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lakeside Community Healthcare Medical Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• 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)
• Lakeview Hospice Care, Inc.
• Lakewood Home Health & Palliative Care Inc

• Family Medicine Physician in Burbank, CA
• Providers in Burbank, CA by specialty
• Family Medicine Physician 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.