LAKESIDE MEDICAL ASSOCIATES, A MEDICAL GROUP, INC. (NPI# 1083879969) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1083879969 |
| Entity Type | Organization |
| Organization Name | LAKESIDE MEDICAL ASSOCIATES, A MEDICAL GROUP, INC. |
| Other Organization Name | LAKESIDE COMMUNITY HEALTHCARE MEDICAL GROUP |
| Practice Address |
3605 Alamo St Suite 100 Simi Valley CA 93063-2186 |
| Mailing Address |
777 Flower Street Suite A Glendale CA 91201-3000 |
| Practice Telephone | 8055226577 |
| Practice Fax Number | 8055227030 |
| Mailing Telephone | 8186372000 |
| Mailing Fax Number | 8182428761 |
| Enumeration Date | 2008-07-21 |
| Last Update Date | 2009-09-04 |
| Authorized Official Name | 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 | 207R00000X | Internal Medicine | Allopathic & Osteopathic Physicians | ||
| N | 363A00000X | Physician Assistant | Physician Assistants & Advanced Practice Nursing Providers | ||
| N | 208D00000X | General Practice | Allopathic & Osteopathic Physicians | ||
| N | 208000000X | Pediatrics | Allopathic & Osteopathic Physicians | ||
| Y | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians |
| 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 |
| 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 |
| 1487859815 | Lakeside Medical Associates, A Medical Group, Inc. | Urology | 25775 Mcbean Pkwy, Suite 107, Valencia, CA 91355-3708 | 2007-06-16 |
| Street Address |
3605 ALAMO ST SUITE 100 |
| City | SIMI VALLEY |
| State | CA |
| Zip Code | 93063-2186 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003809187 | Denise Lu-gee Hom | Family Medicine | 3605 Alamo St, Suite 100, Simi Valley, CA 93063-2186 | 2005-08-24 |
| 1932506326 | Armond Aghakhani | Dentist | 3605 Alamo St, 310, Simi Valley, CA 93063-2186 | 2014-12-01 |
| 1780009498 | Mark Thompson | Physical Therapy Assistant | 3605 Alamo St, Ste 100, Simi Valley, CA 93063-2186 | 2014-03-04 |
| 1346582665 | Southern California Orthopedic Institute, Lp | Orthopaedic Surgery | 3605 Alamo St, Simi Valley, CA 93063-2186 | 2013-03-25 |
| 1962706341 | Shelley B. Kirby | Physician Assistant | 3605 Alamo St, Suite 200, Simi Valley, CA 93063-2186 | 2010-12-29 |
| 1619203247 | Navreet Raju Kamdar | Dentist | 3605 Alamo St, Suite 310, Simi Valley, CA 93063-2186 | 2009-11-02 |
| 1336132422 | Catherine Mcclain Phillips | Physician Assistant | 3605 Alamo St, Ste 100, Simi Valley, CA 93063-2186 | 2005-08-24 |
| 1356334411 | Robert John Brusky | Family Medicine | 3605 Alamo St, Simi Valley, CA 93063-2186 | 2005-08-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467053579 | Renewed Home Health, Inc. | Home Health | 1965 Yosemite Drive #110, Simi Valley, CA 93063 | 2020-11-04 |
| 1467925727 | Shelly Marie Spencer | Marriage & Family Therapist | 1985 Yosemite Ave Ste # 230, Simi Valley, CA 93063 | 2019-01-09 |
| 1245739150 | Hartounian Dental Group Inc. | Dentist | 4210 E Los Angeles Ave Ste F, Simi Valley, CA 93063 | 2018-02-06 |
| 1932628112 | James Luong | Physician Assistant | 3125 Anasazi Way, Simi Valley, CA 93063 | 2017-09-19 |
| 1598291064 | Golden Translating Services Inc | Community/Behavioral Health | 2112 Ralston Ave, Simi Valley, CA 93063 | 2017-05-03 |
| 1447793799 | Kenneth Miles Belden | Social Worker | 3030 Omega Avenue, Simi Valley, CA 93063 | 2016-11-18 |
| 1164979332 | Megan Zigler | Specialist/Technologist | 2127 Atwater Ave, Simi Valley, CA 93063 | 2016-09-06 |
| 1700273521 | Jean Barker | Pharmacist | 5984 Yana Court, Simi Valley, CA 93063 | 2015-04-20 |
| 1992197248 | Pamela A. Riss | Marriage & Family Therapist | 2775 Tapo Street, Suite 204, Simi Valley, CA 93063 | 2015-02-24 |
| 1245580729 | Mary Aroyan | Marriage & Family Therapist | 3655 Alamo St Ste 202, Simi Valley, CA 93063 | 2012-09-12 |
| Find all providers in zip 93063 | ||||
| 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 |
|---|---|---|---|---|
| 1174123038 | Socal Medical Center., Inc. | Family Medicine | 1350 E Los Angeles Ave Ste 204, Simi Valley, CA 93065-2860 | 2020-10-29 |
| 1639717622 | Adventist Health Physicians Network | Family Medicine | 135 Macaw Ln Ste 210, Simi Valley, CA 93065-3153 | 2019-12-20 |
| 1316597230 | K-clear Nursing Inc | Family Medicine | 1822 Springgate Ln Unit G., Simi Valley, CA 93065 | 2019-09-12 |
| 1700439817 | Atc Health Services Inc. | Family Medicine | 1925 Royal Ave Ste B, Simi Valley, CA 93065-4619 | 2019-07-17 |
| 1780242313 | Valencia Medical Inc | Family Medicine | 1526 Patricia Ave, Unit 159, Simi Valley, CA 93065 | 2019-05-29 |
| 1750743530 | Chelsey Colleen Kahanowitch | Family Medicine | 2750 Sycamore Dr Ste 202, Simi Valley, CA 93065-1500 | 2016-03-22 |
| 1235576612 | Maeve W Lin | Family Medicine | 2655 First St, #325, Simi Valley, CA 93065-1548 | 2013-05-26 |
| 1932424926 | Richard David Price Sr. | Family Medicine | 374 Laguna Way, Req, Simi Valley, CA 93065-5315 | 2010-04-01 |
| 1801127162 | Free Clinic of Simi Valley | Family Medicine | 2060 Tapo St., Simi Valley, CA 93063-3417 | 2010-01-26 |
| 1477886539 | Jeffrey M. Caputo | Family Medicine | 2655 First Street Ste 325, Simi Valley, CA 93065-1548 | 2009-09-08 |
| Find all providers in SIMI VALLEY | ||||
| City | SIMI VALLEY |
| Zip Code | 93063 |
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| 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.