Lakeside Medical Associates, a Medical Group, Inc.

Primary specialty

Rheumatology PhysicianTaxonomy code 207RR0500X

Legal business name

LAKESIDE MEDICAL ASSOCIATES, A MEDICAL GROUP, INC.

Doing business as

Lakeside Community Healthcare Medical Group

Practice address

222 W Eulalia St
Suite 200
Glendale, CA 91204-2849

Phone

(818) 291-4010

Fax

(818) 291-4058

NPI assigned

Aug 29, 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 3

Addresses

Other identifiers 1

Other names 1

• Lakeside Community Healthcare Medical Group Doing business as

Locations

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

{
    "created_epoch": "1156809600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1242086400000",
    "number": "1851409874",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "777 FLOWER ST",
            "address_2": "SUITE A",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912013015",
            "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": "222 W EULALIA ST",
            "address_2": "SUITE 200",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912042849",
            "telephone_number": "818-291-4010",
            "fax_number": "818-291-4058"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKESIDE MEDICAL ASSOCIATES, A MEDICAL GROUP, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-29",
        "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_name_prefix": "Dr.",
        "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": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Gastroenterology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RR0500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Rheumatology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0068387",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lakeside Community Healthcare Medical Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jollin Lai, PT, DPT
• Nancy Laines
• Lakeside Medical Associates a Medical Group, Inc.
• Lakeside Medical Associates, a Medical Group, Inc.
• Lakeside Medical Associates, a Medical Group, Inc.
• Lakeside Medical Associates, a Medical Group, Inc.
• Lakeside Medical Group, Inc.
• Lakeside Surgery Center LP
• Aditya Lakhani
• Lalabekyan Dental Inc.

• Rheumatology Physician in Glendale, CA
• Providers in Glendale, CA by specialty
• Rheumatology 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.