LAKESIDE MEDICAL ASSOCIATES, A MEDICAL GROUP, INC. (NPI# 1538323993) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1538323993 |
| Entity Type | Organization |
| Organization Name | LAKESIDE MEDICAL ASSOCIATES, A MEDICAL GROUP, INC. |
| Other Organization Name | LAKESIDE COMMUNITY HEALTHCARE MEDICAL GROUP |
| Practice Address |
612 E Janss Rd Thousand Oaks CA 91360-5113 |
| Mailing Address |
777 Flower Street Suite A Glendale CA 91201-3000 |
| Practice Telephone | 8053730725 |
| Practice Fax Number | 8053730574 |
| Mailing Telephone | 8186372000 |
| Mailing Fax Number | 8182428761 |
| Enumeration Date | 2008-07-15 |
| 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 | 363L00000X | Nurse Practitioner | Physician Assistants & Advanced Practice Nursing Providers | ||
| 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 |
| 1083879969 | Lakeside Medical Associates, A Medical Group, Inc. | Internal Medicine | 3605 Alamo St, Suite 100, Simi Valley, CA 93063-2186 | 2008-07-21 |
| 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 |
612 E JANSS RD |
| City | THOUSAND OAKS |
| State | CA |
| Zip Code | 91360-5113 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093708174 | Verna Silky Li Don Liss | Family Medicine | 612 E Janss Rd, Thousand Oaks, CA 91360-5113 | 2005-08-24 |
| 1124564067 | Robert Behyad Baniasadi | Physical Therapy Assistant | 612 E Janss Rd, Thousand Oaks, CA 91360-5113 | 2017-01-17 |
| 1467499582 | Frederick Stephen Lindberg | Family Medicine | 612 E Janss Rd, Thousand Oaks, CA 91360-5113 | 2006-05-31 |
| 1730159716 | Sherri R Tysch | Pediatrics | 612 E Janss Rd, Thousand Oaks, CA 91360-5113 | 2006-01-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124633953 | Rhandi Walters | Marriage & Family Therapist | 208 E Thousand Oaks Blvd, Suite D, Thousand Oaks, CA 91360 | 2020-09-09 |
| 1942709837 | Stephanie Renee Neri | Behavior Technician | 325 E Hillcrest Dr Suite 140, Thousand Oaks, CA 91360 | 2018-02-06 |
| 1104340652 | Fernando Antonio Castaneda | Student in an Organized Health Care Education/Training Program | 325 E Hillcrest Dr Ste 140, Thousand Oaks, CA 91360 | 2017-07-26 |
| 1023548989 | Anna Garduno | Specialist/Technologist | 3680 Campus Drive, Thousand Oaks, CA 91360 | 2017-06-14 |
| 1467996306 | Ava Shokoufi | Marriage & Family Therapist | 280 E Thousand Oaks Blvd Suite D, Thousand Oaks, CA 91360 | 2016-12-12 |
| 1649621517 | Sandy Lynn Mcglynn | Social Worker | 460 East Gainsborough Road, Thousand Oaks, CA 91360 | 2016-06-22 |
| 1316363476 | Lorraine Jordan | Family Medicine | 1331 Witherspoon Dr, Thousand Oaks, CA 91360 | 2014-03-13 |
| 1841612033 | Katherine Snyder | Counselor | 280 East Thousand Oaks Blvd. Suite D, Thousand Oaks, CA 91360 | 2014-01-08 |
| 1235567397 | Christine Maria Katzenmaier | Speech-Language Pathologist | 223 E. Thousand Oaks Blvd, Thousand Oaks, CA 91360 | 2013-10-28 |
| 1912335233 | Lena Ameripour | Behavioral Analyst | 315 E. Hillcrest Dr., Thousand Oaks, CA 91360 | 2013-10-23 |
| Find all providers in zip 91360 | ||||
| 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 |
|---|---|---|---|---|
| 1275171092 | Quantum Global Health of Riverside | Family Medicine | 299 W Hillcrest Dr Ste 104, Thousand Oaks, CA 91360-7822 | 2019-12-11 |
| 1316363476 | Lorraine Jordan | Family Medicine | 1331 Witherspoon Dr, Thousand Oaks, CA 91360 | 2014-03-13 |
| 1467743864 | Tami Jane Simard | Family Medicine | 3180 Willow Ln Ste 200, Thousand Oaks, CA 91361 | 2011-04-20 |
| 1457530842 | Archana Yogesh Petkar | Family Medicine | 223e Thousand Oaks Blvd, Suite 102, Conejo Valley Family Medical Group, Thousand Oaks, CA 91360 | 2007-11-01 |
| 1942425806 | Catalina Huang | Family Medicine | 3924 Verde Vista, Thousand Oaks, CA 91360 | 2007-04-16 |
| 1053489146 | Community Medical Group Inc | Family Medicine | 612 E Janss Road, Thousand Oaks, CA 91360 | 2006-11-30 |
| 1477640464 | Conejo Oaks Medical Group Inc | Family Medicine | 2100 Lynn Rd Ste 215, Thousand Oaks, CA 91360-8038 | 2006-10-10 |
| 1215041355 | Abilio Ramos | Family Medicine | 223e Thousand Oaks Blvd 211, Thousand Oaks, CA 91360-7743 | 2006-08-18 |
| 1528171352 | Jonathan A Rosaasen | Family Medicine | 187 E Wilbur Rd # 100, Thousand Oaks, CA 91360-5572 | 2006-08-16 |
| 1477583110 | Beverley Kornder | Family Medicine | 425 Haaland Dr, #103, Thousand Oaks, CA 91361-5229 | 2006-07-04 |
| Find all providers in THOUSAND OAKS | ||||
| City | THOUSAND OAKS |
| Zip Code | 91360 |
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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.