Lakeside Medical Associates, a Medical Group, Inc.

Primary specialty

Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X

Legal business name

LAKESIDE MEDICAL ASSOCIATES, A MEDICAL GROUP, INC.

Doing business as

Lakeside Community Healthcare Medical Group

Practice address

1500 S Central Ave
Suite 326
Glendale, CA 91204-2530

Phone

(818) 956-8582

Fax

(818) 956-0329

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 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": "1181952000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1242000000000",
    "number": "1659576072",
    "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": "1500 S CENTRAL AVE",
            "address_2": "SUITE 326",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912042530",
            "telephone_number": "818-956-8582",
            "fax_number": "818-956-0329"
        }
    ],
    "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": "207RE0101X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR006838C",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lakeside Community Healthcare Medical Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Victoria Lahaye
• Jollin Lai, PT, DPT
• Nancy Laines
• 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 Group, Inc.
• Lakeside Surgery Center LP
• Aditya Lakhani

• Endocrinology, Diabetes & Metabolism Physician in Glendale, CA
• Providers in Glendale, CA by specialty
• Endocrinology, Diabetes & Metabolism 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.