LAKESIDE MEDICAL ASSOCIATES, A MEDICAL GROUP, INC. (NPI# 1659317634) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1659317634 |
| Entity Type | Organization |
| Organization Name | LAKESIDE MEDICAL ASSOCIATES, A MEDICAL GROUP, INC. |
| Other Organization Name | LAKESIDE COMMUNITY HEALTHCARE MEDICAL GROUP |
| Practice Address |
24355 Lyons Ave Suite 210 Santa Clarita CA 91321-2300 |
| Mailing Address |
777 Flower St Suite A Glendale CA 91201-3015 |
| Practice Telephone | 6612229381 |
| Practice Fax Number | 6612222264 |
| Mailing Telephone | 8186372000 |
| Mailing Fax Number | 8182428761 |
| Enumeration Date | 2006-06-20 |
| Last Update Date | 2009-05-06 |
| 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 | 363L00000X | Nurse Practitioner | CA | Physician Assistants & Advanced Practice Nursing Providers | |
| N | 207N00000X | Dermatology | Allopathic & Osteopathic Physicians | ||
| N | 207R00000X | Internal Medicine | Allopathic & Osteopathic Physicians | ||
| N | 208000000X | Pediatrics | Allopathic & Osteopathic Physicians | ||
| Y | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | GR0068381 | 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 |
24355 LYONS AVE SUITE 210 |
| City | SANTA CLARITA |
| State | CA |
| Zip Code | 91321-2300 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710981626 | James P. De La Flor | Internal Medicine | 24355 Lyons Ave, Ste 210, Santa Clarita, CA 91321-2381 | 2005-06-08 |
| 1063838217 | Valerie Jean Malinoski | Nurse Practitioner | 24355 Lyons Ave, Santa Clarita, CA 91321-2300 | 2014-03-12 |
| 1629364989 | Baumgartner Physical Therapy Inc | Physical Therapist | 24355 Lyons Ave, Suite 100, Santa Clarita, CA 91321-2332 | 2011-06-24 |
| 1548458870 | William J. Quinn | Physician Assistant | 24355 Lyons Ave, Suite 130, Santa Clarita, CA 91321-2300 | 2007-10-11 |
| 1093903494 | Mehdi Meratee Md Inc | Psychiatry & Neurology | 24355 Lyons Ave, 214, Santa Clarita, CA 91321-2300 | 2007-10-10 |
| 1588856215 | Peter Nicolazzo, M.d., Inc | Anesthesiology | 24355 Lyons Ave, Ste.# 120, Santa Clarita, CA 91321-2300 | 2007-08-16 |
| 1447441712 | Vista Village Dental | Dentist | 24355 Lyons Ave, Ste 212, Santa Clarita, CA 91321-2300 | 2007-08-05 |
| 1225237464 | K D Lewis Anesthesia Inc | Anesthesiology | 24355 Lyons Ave, Ste. #120, Santa Clarita, CA 91321-2300 | 2007-07-17 |
| 1710186416 | Benjamin Li, M.d., Inc | Anesthesiology | 24355 Lyons Ave, Ste.# 120, Santa Clarita, CA 91321-2300 | 2007-07-12 |
| 1770709479 | Steve Baumgartner | Physical Therapist | 24355 Lyons Ave, Suite 100, Santa Clarita, CA 91321-2300 | 2007-04-18 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275157265 | Lauren Tolcher | Behavioral Analyst | 23502 Lyons Avenue, Suite 304a, Santa Clarita, CA 91321 | 2020-06-04 |
| 1427613900 | Weston William Lensing | Behavior Technician | 3502 Lyons Ave, Ste 304a, Santa Clarita, CA 91321 | 2019-05-09 |
| 1174005003 | Eparthenos | Psychologist | 23504 Lyons Ave #304, Santa Clarita, CA 91321 | 2018-09-06 |
| 1740761105 | The Center for Creative Therapy, Inc | Marriage & Family Therapist | 23030 Lyons Ave Ste 207, Santa Clarita, CA 91321 | 2018-08-23 |
| 1982196879 | Brandi Wright-dohopolski | Acupuncturist | 27820 Freemont Court, Unit 5, Suite E, Valencia, CA 91321 | 2018-06-06 |
| 1780113209 | Jennifer Ann Woods | Physician Assistant | 23645 Meadowridge Drive, 110, Newhall, CA 91321 | 2017-06-08 |
| 1942661624 | Sina Tebi Md Inc | Internal Medicine | 23938 Lyons Avenue, #204, Newhall, CA 91321 | 2016-03-09 |
| 1720452220 | Julie Kim | Pharmacist | 26863 Sierra Hwy, Santa Clarita, CA 91321 | 2015-11-20 |
| 1568855773 | Carly Nikiforuk | Counselor | 24625 Arch St., Newhall, CA 91321 | 2015-03-12 |
| 1437562741 | Teresa Cha Waggoner | Nurse Practitioner | 23772 Newhall Avenue, Newhall, CA 91321 | 2014-06-04 |
| Find all providers in zip 91321 | ||||
| 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 |
|---|---|---|---|---|
| 1689163990 | Joash Kipkurui Kemei | Family Medicine | 28901 Dune Ln Apt 103, Santa Clarita, CA 91387-2126 | 2018-05-02 |
| 1962932145 | Andrew Ugurian | Family Medicine | 14550 Soledad Canyon Road, Santa Clarita, CA 91387-2200 | 2017-06-19 |
| 1144451824 | Delaram Danaei | Family Medicine | 18533 Soledad Canyon Rd, Santa Clarita, CA 91351-3722 | 2009-07-29 |
| 1255426383 | Northwest Valley Family Medical Clinic, Inc. | Family Medicine | 21700 Golden Triangle Road, # 105, Santa Clarita, CA 91350 | 2006-10-04 |
| 1053353763 | Daisy Mae Cabalquinto Markley | Family Medicine | 27924 Seco Canyon Rd, Santa Clarita, CA 91350-3870 | 2006-06-10 |
| 1811949449 | Rafael A Rosado-cosme | Family Medicine | 26877 Tourney Rd, Santa Clarita, CA 91355-1846 | 2006-05-16 |
| 1265484877 | Michael Pin | Family Medicine | 24035 Newhall Ranch Rd, Santa Clarita, CA 91355-5702 | 2006-05-16 |
| 1578527255 | Corina Ngo Chin | Family Medicine | 19042 Soledad Canyon Rd, Santa Clarita, CA 91351-3362 | 2006-04-12 |
| 1972965572 | Armond Ohanian | Family Medicine | 26877 Tourney Rd, Santa Clarita, CA 91355-1846 | 2016-03-23 |
| 1528408473 | Irina Chernishof | Family Medicine | 27107 Tourney Rd, Santa Clarita, CA 91355-1860 | 2013-06-25 |
| Find all providers in SANTA CLARITA | ||||
| City | SANTA CLARITA |
| Zip Code | 91321 |
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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.