LAKESIDE MEDICAL ASSOCIATES, A MEDICAL GROUP, INC. (NPI# 1043256027) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1043256027 |
| Entity Type | Organization |
| Organization Name | LAKESIDE MEDICAL ASSOCIATES, A MEDICAL GROUP, INC. |
| Other Organization Name | LAKESIDE COMMUNITY HEALTHCARE MEDICAL GROUP |
| Practice Address |
607 S Glenoaks Blvd Burbank CA 91502-1424 |
| Mailing Address |
777 Flower St Suite A Glendale CA 91201-3015 |
| Practice Telephone | 8185572671 |
| Practice Fax Number | 8185570761 |
| Mailing Telephone | 8186372000 |
| Mailing Fax Number | 8182428761 |
| Enumeration Date | 2006-06-20 |
| Last Update Date | 2009-05-12 |
| Authorized Official Name | DR. KERRY E. WEINER (PRESIDENT) |
| Authorized Official Telephone | 8186372000 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363L00000X | Nurse Practitioner | CA | Physician Assistants & Advanced Practice Nursing Providers | |
| N | 207R00000X | Internal Medicine | Allopathic & Osteopathic Physicians | ||
| N | 207RR0500X |
Internal Medicine Specialization: Rheumatology |
Allopathic & Osteopathic Physicians | ||
| N | 208000000X | Pediatrics | Allopathic & Osteopathic Physicians | ||
| Y | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | GR0068382 | 05 |
| Other Name | Type Code |
|---|---|
| Lakeside Community Healthcare Medical Group | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104072339 | Lakeside Medical Associates, A Medical Group, Inc. | Obstetrics & Gynecology | 7345 Medical Center Drive, Suite 500, West Hills, CA 91307-1964 | 2008-08-07 |
| 1962667857 | Lakeside Medical Associates, A Medical Group, Inc. | Obstetrics & Gynecology | 191 S Buena Vista St, Suite 440, Burbank, CA 91505-4504 | 2008-07-21 |
| 1801051784 | Lakeside Medical Associates, A Medical Group, Inc. | Internal Medicine | 1500 W West Covina Pkwy, West Covina, CA 91790-2708 | 2008-07-21 |
| 1083879969 | Lakeside Medical Associates, A Medical Group, Inc. | Internal Medicine | 3605 Alamo St, Suite 100, Simi Valley, CA 93063-2186 | 2008-07-21 |
| 1538323993 | Lakeside Medical Associates, A Medical Group, Inc. | Internal Medicine | 612 E Janss Rd, Thousand Oaks, CA 91360-5113 | 2008-07-15 |
| 1104001288 | Lakeside Medical Associates, A Medical Group, Inc. | Internal Medicine | 1500 S Central Ave, Suite 320, Glendale, CA 91204-2530 | 2008-01-08 |
| 1689869760 | Lakeside Medical Associates, A Medical Group, Inc. | Family Medicine | 12660 Riverside Dr, Suite 225, N Hollywood, CA 91607-3429 | 2007-09-11 |
| 1689874596 | Lakeside Medical Associates, A Medical Group, Inc. | Emergency Medicine | 191 S Buena Vista St, Suite 150, Burbank, CA 91505-4554 | 2007-07-19 |
| 1639374069 | Lakeside Medical Associates, A Medical Group, Inc. | Internal Medicine | 4835 Van Nuys Blvd, Suite 114, Sherman Oaks, CA 91403-2109 | 2007-06-16 |
| 1659576072 | Lakeside Medical Associates, A Medical Group, Inc. | Internal Medicine | 1500 S Central Ave, Suite 326, Glendale, CA 91204-2530 | 2007-06-16 |
| Street Address |
607 S GLENOAKS BLVD |
| City | BURBANK |
| State | CA |
| Zip Code | 91502-1424 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578567822 | Gitte S. Bloom | Pediatrics | 607 S Glenoaks Blvd, Burbank, CA 91502-1424 | 2005-06-01 |
| 1043415383 | Diana Dermendjian | Family Medicine | 607 S Glenoaks Blvd, Burbank, CA 91502-1424 | 2007-06-18 |
| 1245232354 | Lynn A Parolise | Registered Nurse | 607 S Glenoaks Blvd, Burbank, CA 91502-1424 | 2005-06-01 |
| 1306840665 | Elizabeth C Reeves | Family Medicine | 607 S Glenoaks Blvd, Burbank, CA 91502-1424 | 2005-06-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689211658 | 1st Response Hospice, Inc. | Hospice Care, Community Based | 801 S Glenoaks Blvd Suite 200, Glendale, CA 91502 | 2019-12-09 |
| 1588216816 | Brookdale Hospice, Inc. | Home Health | 3089 N. Lima St. # F, Burbank, CA 91502 | 2019-07-16 |
| 1386200251 | Bestcare Transportation LLC. | Non-emergency Medical Transport (VAN) | 40 E. Verdugo Ave., Burbank, CA 91502 | 2019-05-15 |
| 1548619331 | Natalie Gold, Inc. | Pharmacy | 140 N. San Fernando Rd, Burbank, CA 91502 | 2016-06-13 |
| 1437578291 | Advance Sleep Center Inc | Specialist/Technologist, Other | 325 N Victory Blvd, Burbank, CA 91502 | 2014-04-09 |
| 1225397086 | Burbank Village Compounding Pharmacy Inc | Pharmacy | 337 E Magnolia Blvd, Burbank, CA 91502 | 2012-05-14 |
| 1942570015 | Urgent Hospice Care Inc | Home Health | 224 E. Olive St #216, Burbank, CA 91502 | 2012-01-06 |
| 1750659306 | Encore Hospice Corp | Home Health | 271 W. Alameda Ave, Burbank, CA 91502 | 2011-12-12 |
| 1255615548 | California Hospice Corp | Hospice Care, Community Based | 905 S. Lake St, Suite 201 and 202 and 202, Burbank, CA 91502 | 2011-10-05 |
| 1154609808 | Arin Hayrapetian | Dentist | 635 N Victory Pl, Burbank, CA 91502 | 2011-07-29 |
| Find all providers in zip 91502 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770932204 | Sam Fatoorehchi | Family Medicine | 4901 W 79th St Fl 2, Burbank, IL 60459-1569 | 2016-06-06 |
| 1750768685 | Rasha William Atallah | Family Medicine | 4901 W 79th St Ste 10, Burbank, IL 60459-1554 | 2015-04-29 |
| 1477949618 | Ciara L Shirvanian | Family Medicine | 191 S. Buena Vista Street, Suite #100, Burbank, CA 91505-4554 | 2015-04-14 |
| 1346678794 | M & C Physician Solutions PC | Family Medicine | 640 N Keystone St, Suite B, Burbank, CA 91506-1900 | 2013-10-22 |
| 1265732176 | Syeda Kulsoom Ali | Family Medicine | 4901 W 79th St Floor 2, Burbank, IL 60459 | 2010-10-26 |
| 1881915627 | Mahin Ghanevati | Family Medicine | 191 S Buena Vista St Ste 220, Burbank, CA 91505-4563 | 2010-06-16 |
| 1336467620 | Treasa L Davis | Family Medicine | 191 S Buena Vista St Ste 375, Burbank, CA 91505-4558 | 2010-05-11 |
| 1982935268 | Lynn Joseph Ramirez, M.d. Inc. | Family Medicine | 303 S Glenoaks Blvd Ste 4, Burbank, CA 91502-1193 | 2010-01-26 |
| 1538310172 | West Suburban Medical Ctr. | Family Medicine | 8333 South Austin, Burbank, IL 60459-2558 | 2008-10-01 |
| 1952560732 | Liana Poghosyan | Family Medicine | 401 S Glenoaks Blvd Ste 101, Burbank, CA 91502-2707 | 2008-06-05 |
| Find all providers in BURBANK | ||||
Please comment or provide details below to improve the information on LAKESIDE MEDICAL ASSOCIATES, A MEDICAL GROUP, INC..
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.