NPIMap

Organization Active NPI

Lakeside Medical Organization, a Medical Group Inc.

  • Internal Medicine Physician
  • West Hills, CA
National Provider Identifier
1831426642
Registry record updated Sep 3, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
LAKESIDE MEDICAL ORGANIZATION, A MEDICAL GROUP INC.
Practice address
8501 Fallbrook Ave Ste 300
West Hills, CA 91304-3269
Phone
(818) 654-3400
Fax
(818) 933-0525
NPI assigned
Nov 16, 2009
Last updated
Sep 3, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 3, 2026

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

Authorized official

Name
Jessica Arce-Gomez
Title
Credentialing Supervisor
Phone
(818) 654-3400

Specialties & licenses 15

Specialty (taxonomy)CodeLicenseStatePrimary
Urgent Care Clinic/Center 261QU0200X NU
Dermatology Physician 207N00000X NU
Family Medicine Physician 207Q00000X NU
Internal Medicine Physician 207R00000X NU Primary
Cardiovascular Disease Physician 207RC0000X NU
Endocrinology, Diabetes & Metabolism Physician 207RE0101X NU
Gastroenterology Physician 207RG0100X NU
Rheumatology Physician 207RR0500X NU
Obstetrics & Gynecology Physician 207V00000X NU
Pediatrics Physician 208000000X NU
Physical Medicine & Rehabilitation Physician 208100000X NU
Body Imaging Physician 2085B0100X NU
Surgery Physician 208600000X NU
Urology Physician 208800000X NU
Podiatrist 213E00000X NU

Addresses

Primary practice location

8501 Fallbrook Ave Ste 300
West Hills, CA 91304-3269

Mailing address

8501 Fallbrook Ave Ste 300
West Hills, CA 91304-3269
Phone (818) 654-3400

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100505000015 CA Part B Supplier - Clinic/Group Practice 7618005166 Receives reassigned benefits from 236 practitioners
Practice locations: West Hills, CA; West Covina, CA; Thousand Oaks, CA; Santa Clarita, CA; Northridge, CA; North Hollywood, CA; Mission Hills, CA; Burbank, CA…

National Provider Directory

National Provider Directory

Locations

101 S 1st St
Ste 1800
Burbank, CA 91502
Phone (818) 558-7252

101 S 1st St
Ste 301
Burbank, CA 91502
Phone (818) 558-7252

191 S Buena Vista St
Ste 200
Burbank, CA 91505
Phone (818) 887-2671

191 S Buena Vista St
Ste 400
Burbank, CA 91505
Phone (818) 818-0023

191 S Buena Vista St
Ste 420440
Burbank, CA 91505
Phone (818) 848-0023

777 Flower St
Ste A
Glendale, CA 91201
Phone (818) 637-2000

14901 Rinaldi St
Ste 200201
Mission Hills, CA 91345
Phone (818) 365-8553

18546 Roscoe Blvd
Ste 302
Northridge, CA 91324
Phone (818) 886-1100

8510 Balboa Blvd
Ste 150
Northridge, CA 91325
Phone (818) 637-2000

24355 Lyons Ave
Ste 210
Santa Clarita, CA 91321
Phone (661) 222-9381

2755 Alamo St
Ste 100
Simi Valley, CA 93065
Phone (626) 791-9004

3605 Alamo St
Ste 100
Simi Valley, CA 93063
Phone (805) 522-6577

3655 Alamo St
Ste 100
Simi Valley, CA 93063
Phone (805) 210-7111

1500 W West Covina Pkwy
West Covina, CA 91790
Phone (626) 430-9991

7325 Medical Ctr
Ste 300
West Hills, CA 91307
Phone (818) 226-3666

Networks

  • BSC 65 PLUS INDIVIDUAL MAPDPlans: Blue Shield 65 Plus (HMO) (H0504-015-000, H0504); Blue Shield 65 Plus (HMO) (H0504-039-000, H0504); Blue Shield 65 Plus Plan 2 (HMO) (H0504-021-000, H0504); Blue Shield Inspire (HMO) (H0504-041-000, H0504); Blue Shield 65 Plus (HMO) (H0504-038-000, H0504); Blue Shield Inspire (HMO) (H0504-047-000, H0504); Blue Shield 65 Plus (HMO) (H0504-026-000, H0504); Blue Shield Advantage (HMO) (H0504-050-000, H0504); Blue Shield AdvantageOptimum Plan (HMO) (H5928-004-000, H5928); Blue Shield Inspire (HMO) (H0504-043-000, H0504)…

Practitioners & affiliated clinicians

Practitioners 303

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.

View all 303

NPI Registry JSON

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

{
    "created_epoch": "1258329600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1788393600000",
    "number": "1831426642",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8501 FALLBROOK AVE STE 300",
            "city": "WEST HILLS",
            "state": "CA",
            "postal_code": "913043269",
            "telephone_number": "818-654-3400",
            "fax_number": "818-933-0525"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8501 FALLBROOK AVE STE 300",
            "city": "WEST HILLS",
            "state": "CA",
            "postal_code": "913043269",
            "telephone_number": "818-654-3400",
            "fax_number": "818-933-0525"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKESIDE MEDICAL ORGANIZATION, A MEDICAL GROUP INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-11-16",
        "last_updated": "2026-09-03",
        "certification_date": "2026-09-03",
        "status": "A",
        "authorized_official_last_name": "ARCE-GOMEZ",
        "authorized_official_first_name": "JESSICA",
        "authorized_official_title_or_position": "CREDENTIALING SUPERVISOR",
        "authorized_official_telephone_number": "818-654-3400"
    },
    "taxonomies": [
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207RR0500X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Rheumatology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2085B0100X",
            "taxonomy_group": "",
            "desc": "Radiology, Body Imaging",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Hills, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.