LAKESIDE MEDICAL ASSOCIATES, A MEDICAL GROUP, INC. (NPI# 1801051784) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1801051784 |
| Entity Type | Organization |
| Organization Name | LAKESIDE MEDICAL ASSOCIATES, A MEDICAL GROUP, INC. |
| Other Organization Name | LAKESIDE COMMUNITY HEALTHCARE MEDICAL GROUP |
| Practice Address |
1500 W West Covina Pkwy West Covina CA 91790-2708 |
| Mailing Address |
777 Flower Street Suite A Glendale CA 91201-3000 |
| Practice Telephone | 6264309991 |
| Practice Fax Number | 6269603726 |
| Mailing Telephone | 8186372000 |
| Mailing Fax Number | 8182428761 |
| Enumeration Date | 2008-07-21 |
| Last Update Date | 2009-10-19 |
| 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 | 207VG0400X |
Obstetrics & Gynecology Specialization: Gynecology |
Allopathic & Osteopathic Physicians | ||
| N | 208000000X | Pediatrics | Allopathic & Osteopathic Physicians | ||
| N | 208600000X | Surgery | Allopathic & Osteopathic Physicians | ||
| N | 207RG0100X |
Internal Medicine Specialization: Gastroenterology |
Allopathic & Osteopathic Physicians | ||
| N | 207N00000X | Dermatology | Allopathic & Osteopathic Physicians | ||
| N | 363A00000X | Physician Assistant | Physician Assistants & Advanced Practice Nursing Providers | ||
| N | 363LX0001X |
Nurse Practitioner Specialization: Obstetrics & Gynecology |
Physician Assistants & Advanced Practice Nursing Providers | ||
| N | 363L00000X | Nurse Practitioner | Physician Assistants & Advanced Practice Nursing Providers | ||
| 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 |
| 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 |
| 1487859815 | Lakeside Medical Associates, A Medical Group, Inc. | Urology | 25775 Mcbean Pkwy, Suite 107, Valencia, CA 91355-3708 | 2007-06-16 |
| Street Address |
1500 W WEST COVINA PKWY |
| City | WEST COVINA |
| State | CA |
| Zip Code | 91790-2708 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922057256 | Ruth Manjula Karunananthan | Internal Medicine | 1500 W West Covina Pkwy, Ste 102, West Covina, CA 91790-2703 | 2006-05-05 |
| 1023483385 | Kamlesh T Mania | Pharmacist | 1500 W West Covina Pkwy, Suite 100, West Covina, CA 91790-2708 | 2015-12-11 |
| 1265688337 | Katherine Footracer | Physician Assistant | 1500 W West Covina Pkwy, West Covina, CA 91790-2708 | 2008-08-08 |
| 1407047756 | Darrell Anthony Carter | Physician Assistant | 1500 W West Covina Pkwy, West Covina, CA 91790-2708 | 2007-08-01 |
| 1114040235 | Eliot Alan Waron | Physician Assistant | 1500 W West Covina Pkwy, Ste 102, West Covina, CA 91790-2703 | 2007-04-06 |
| 1386789311 | West Covina Medical Clinic | Internal Medicine | 1500 W West Covina Pkwy, West Covina, CA 91790-2707 | 2007-02-20 |
| 1114082542 | Pnk Pharmacy, Inc. | Pharmacy | 1500 W West Covina Pkwy, Ste 100, West Covina, CA 91790-2708 | 2006-12-26 |
| 1477561496 | Clara Edobor | Nurse Practitioner | 1500 W West Covina Pkwy, West Covina, CA 91790-2708 | 2006-08-04 |
| 1679523682 | Suneetha Sajid Ali | Obstetrics & Gynecology | 1500 W West Covina Pkwy, Ste 203, West Covina, CA 91790-2703 | 2006-05-11 |
| 1497705289 | Van Hong Duong | Family Medicine | 1500 W West Covina Pkwy, Ste 101, West Covina, CA 91790-2703 | 2006-05-11 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285279067 | Liang-wen Chen | Acupuncturist | 1433 West Merced Ave. Suite 304, West Covina, CA 91790 | 2019-11-15 |
| 1245880517 | Cheuk Man Chan | Acupuncturist | 1433 W Merced Ave., #309, West Covina, CA 91790 | 2019-09-18 |
| 1982174561 | Alexandra Isaacs | Marriage & Family Therapist | 1215 W. West Covina Pkwy., West Covina, CA 91790 | 2018-11-27 |
| 1568949709 | Lulua Zulfikarali Bahrainwala | Student in an Organized Health Care Education/Training Program | 1115 S Sunset Avenue #3940, West Covina, CA 91790 | 2018-07-20 |
| 1417442740 | Lydia Joy David | Nurse Practitioner | 1769 S Sunset Ave, West Covina, CA 91790 | 2018-06-28 |
| 1043721046 | Kimberly E Nevarez | Specialist/Technologist | 410 E Merced Ave Suite D, Suite D, West Covina, CA 91790 | 2017-10-17 |
| 1952825754 | Evan Lee Hendriks | Physician Assistant | 301 S Glendora Ave, Apt 2142, West Covina, CA 91790 | 2017-08-02 |
| 1669994588 | Meryl Francine Liu | Dentist | 1101 S. Glendora Ave #a, West Covina, CA 91790 | 2017-07-12 |
| 1326586330 | Athena Merianos | Marriage & Family Therapist | 1215 W. West Parkway, West Covina, CA 91790 | 2017-02-09 |
| 1912445990 | Lissette Bueno | Case Manager/Care Coordinator | 1517 West Garvey Ave North, West Covina, CA 91790 | 2017-02-09 |
| Find all providers in zip 91790 | ||||
| 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 |
|---|---|---|---|---|
| 1427672385 | California Mobile Doctors Group Inc | Family Medicine | 1317 W West Covina Pkwy Ste B, West Covina, CA 91790-2800 | 2020-06-05 |
| 1447881024 | Steven Mitchell Villalobos | Family Medicine | 2645 E Charlinda St, West Covina, CA 91791-2901 | 2020-01-31 |
| 1184199275 | Mobile Physicians Medical Allied Group Inc | Family Medicine | 1317 W West Covina Pkwy Ste F, West Covina, CA 91790-2800 | 2018-10-04 |
| 1033573043 | Cynthia Chen-joea | Family Medicine | 1115 S. Sunset Ave, West Covina, CA 91790 | 2016-04-06 |
| 1518271964 | Huy Tu Nguyen | Family Medicine | 1500 W. West Covina Parkway, Suite 101, West Covina, CA 91790 | 2010-07-27 |
| 1659604023 | Allen A. Hassen | Family Medicine | 3121 E Hillside Dr, West Covina, CA 91791-3459 | 2009-09-16 |
| 1720214729 | Bernadette P Alejandrino | Family Medicine | 767 S Sunset Ave Ste 8, West Covina, CA 91790-3546 | 2009-06-04 |
| 1639233166 | Shine Medical Group Inc. | Family Medicine | 1901 W Badillo St, West Covina, CA 91790-1133 | 2006-12-20 |
| 1922160845 | Sisira Gunawardane Md Inc | Family Medicine | 333 N Sunset Ave, West Covina, CA 91790 | 2006-12-15 |
| 1619044435 | Marialuz Sevilla-herrera | Family Medicine | 1135 S Sunset Ave Ste 211, West Covina, CA 91790-3938 | 2006-11-29 |
| Find all providers in WEST COVINA | ||||
| City | WEST COVINA |
| Zip Code | 91790 |
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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.