LAKESIDE MEDICAL ASSOCIATES, A MEDICAL GROUP, INC. (NPI# 1104001288) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104001288 |
| Entity Type | Organization |
| Organization Name | LAKESIDE MEDICAL ASSOCIATES, A MEDICAL GROUP, INC. |
| Other Organization Name | LAKESIDE COMMUNITY HEALTHCARE MEDICAL GROUP |
| Practice Address |
1500 S Central Ave Suite 320 Glendale CA 91204-2530 |
| Mailing Address |
777 Flower St Suite A Glendale CA 91201-3015 |
| Practice Telephone | 8182473708 |
| Practice Fax Number | 8185473146 |
| Mailing Telephone | 8186372000 |
| Mailing Fax Number | 8182428761 |
| Enumeration Date | 2008-01-08 |
| Last Update Date | 2009-05-11 |
| 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 |
|---|---|---|---|---|---|
| Y | 207RC0000X |
Internal Medicine Specialization: Cardiovascular Disease |
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 |
| 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 |
| 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 |
1500 S CENTRAL AVE SUITE 320 |
| City | GLENDALE |
| State | CA |
| Zip Code | 91204-2530 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922088459 | Serena A Tu | Pediatrics | 1500 S Central Ave, Suite 100, Glendale, CA 91204-2530 | 2006-01-19 |
| 1427509033 | Interventional Spine Care & Orthopedic Regenerative Experts | Physical Medicine & Rehabilitation | 1500 S Central Ave, Suite 101, Glendale, CA 91204-2530 | 2016-10-18 |
| 1215298286 | Western Podmed Clinic Inc | Podiatrist | 1500 S Central Ave, Suite 323, Glendale, CA 91204-3858 | 2012-06-06 |
| 1811261266 | Anahit Hovhannisyan | Nutritionist | 1500 S Central Ave, 321, Glendale, CA 91204-2530 | 2012-03-02 |
| 1801185095 | Danny Zaghi | Internal Medicine | 1500 S Central Ave, Ste 200, Glendale, CA 91204-2530 | 2011-03-29 |
| 1831406768 | Janet Aleksanyan | Registered Nurse | 1500 S Central Ave, Suite 322, Glendale, CA 91204-2530 | 2010-09-14 |
| 1376857276 | Claudia Dominguez | Dietitian, Registered | 1500 S Central Ave, Suite 221, Glendale, CA 91204-2530 | 2010-08-03 |
| 1386958353 | Satindar Dua | Dietitian, Registered | 1500 S Central Ave, Suite 221, Glendale, CA 91204-2530 | 2010-08-02 |
| 1538488333 | Melina Karabetyan Sukyas | Physician Assistant | 1500 S Central Ave, Suite 300, Glendale, CA 91204-2530 | 2010-05-19 |
| 1457675324 | Jon I. Sattler, M.d., Inc. | Plastic Surgery | 1500 S Central Ave, Suite 126, Glendale, CA 91204-2530 | 2010-03-22 |
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| 1558997387 | Hope & Trust Trading LLC | Radiology | 318 W Colorado St #2, Glendale, CA 91204 | 2020-03-12 |
| 1972133387 | Yusuf Toliver | Counselor | 1027 S Central Ave, Suite 200, Glendale, CA 91204 | 2020-01-24 |
| 1538633136 | Pathology La Inc. | Clinical Medical Laboratory | 4634 San Fernando Rd., Same As Above, Glendale, CA 91204 | 2019-01-16 |
| 1295254050 | Glendale Back and Pain Center | Neurological Surgery | 710 S. Central Ave, Suite 240, Glendale, CA 91204 | 2017-09-13 |
| 1285163568 | Ez Trans, Inc. | Transportation Broker | 1626 S. Central Ave., Glendale, CA 91204 | 2017-06-08 |
| 1194254474 | Jenny Chung | Pharmacist | 3943 San Fernando Road, Glendale, CA 91204 | 2017-06-08 |
| 1396111886 | Fresenius Medical Care Glendale, LLC | Clinic/Center | 623 S Central Ave, Glendale, CA 91204 | 2015-08-19 |
| 1710302450 | New Age Foot and Ankle Podiatry PC | Podiatrist | 705 Ivy Street, Glendale, CA 91204 | 2014-03-04 |
| 1124454376 | Alber K. Karamanoukian Medical Clinic, Inc. | Clinic/Center | 810 S. Central Avenue, Suite 100, Glendale, CA 91204 | 2013-09-19 |
| 1548521156 | Glendale Plastic and Reconstructive Surgery Inc. | Plastic Surgery | 1500 S. Central Ave. #126, Glendale, CA 91204 | 2012-05-31 |
| Find all providers in zip 91204 | ||||
| Taxonomy Code | 207RC0000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Cardiovascular Disease |
| An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms. |
| Notes: Source: American Osteopathic Board of Internal Medicine, 2008 [7/1/2008: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, http://www.abim.org/. American Osteopathic Board of Internal Medicine, https://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
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|---|---|---|---|---|
| 1962967059 | Adventist Health Physicians Network | Internal Medicine | 1808 Verdugo Blvd Ste 414, Glendale, CA 91208-1474 | 2019-02-04 |
| 1972030427 | Advanced Medical & Surgical Ventures, Inc. | Internal Medicine | 217 S Glendale Ave, Glendale, CA 91205-1713 | 2017-05-15 |
| 1326438276 | Healthfinity, Pllc | Internal Medicine | 6316 W Union Hills Dr Ste 210, Glendale, AZ 85308-1001 | 2015-01-30 |
| 1336411503 | Santo Salvatore Polito | Internal Medicine | 3255 Beaudry Ter, Glendale, CA 91208-1700 | 2012-02-03 |
| 1457504029 | Daniel Aram Daneshvar | Internal Medicine | 1510 S Central Ave Ste 150, Glendale, CA 91204-2541 | 2008-10-28 |
| 1760678049 | Jigar Anilkumar Patel | Internal Medicine | 18700 N 64th Dr Ste 101, Glendale, AZ 85308-7110 | 2007-09-19 |
| 1003009861 | Moustafa Banna | Internal Medicine | 5859 W. Talavi Blvd, Suite 100, Glendale, AZ 85306-1869 | 2007-08-23 |
| 1629270731 | Dipak Jana | Internal Medicine | 5422 W Thunderbird Rd Ste 8, Glendale, AZ 85306-4717 | 2007-06-01 |
| 1316156797 | Hossein Dehghani | Internal Medicine | 1560 E Chevy Chase Dr Ste 445, Glendale, CA 91206-4154 | 2007-05-22 |
| 1265644140 | Anthony B Alvaro | Internal Medicine | 1134 Orange Grove Ave, Glendale, CA 91205-1334 | 2007-05-04 |
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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.