LAKESIDE MEDICAL ASSOCIATES, A MEDICAL GROUP, INC. (NPI# 1962667857) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1962667857 |
| Entity Type | Organization |
| Organization Name | LAKESIDE MEDICAL ASSOCIATES, A MEDICAL GROUP, INC. |
| Other Organization Name | LAKESIDE COMMUNITY HEALTHCARE MEDICAL GROUP |
| Practice Address |
191 S Buena Vista St Suite 440 Burbank CA 91505-4504 |
| Mailing Address |
777 Flower Street Suite A Glendale CA 91201-3000 |
| Practice Telephone | 8188483763 |
| Practice Fax Number | 8188483785 |
| Mailing Telephone | 8186372000 |
| Mailing Fax Number | 8182428761 |
| Enumeration Date | 2008-07-21 |
| 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 | 207V00000X | Obstetrics & Gynecology | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | 1962667857 | 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 |
| 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 |
| 1487859815 | Lakeside Medical Associates, A Medical Group, Inc. | Urology | 25775 Mcbean Pkwy, Suite 107, Valencia, CA 91355-3708 | 2007-06-16 |
| Street Address |
191 S BUENA VISTA ST SUITE 440 |
| City | BURBANK |
| State | CA |
| Zip Code | 91505-4504 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134123474 | Kenneth Ballan | Internal Medicine | 191 S Buena Vista St, Ste. 215, Burbank, CA 91505-4554 | 2005-06-01 |
| 1114467255 | Ann Grosch | Audiologist-Hearing Aid Fitter | 191 S Buena Vista St, Suite 320-a, Burbank, CA 91505-4554 | 2017-03-07 |
| 1912443490 | Genesis Functional Restoration Clinic Inc | Family Medicine | 191 S Buena Vista St, 335, Burbank, CA 91505-4554 | 2017-01-09 |
| 1902342496 | Genesis Occupational Medical Clinic Inc | Family Medicine | 191 S Buena Vista St, 335, Burbank, CA 91505-4554 | 2017-01-09 |
| 1750763041 | Stetson Powell Orthopedics and Sports Medicine | Specialist | 191 S Buena Vista St, Suite 470, Burbank, CA 91505-4554 | 2015-06-23 |
| 1124407119 | Hesam Hekmatjou | Family Medicine | 191 S Buena Vista St, Suite 100, Burbank, CA 91505-4554 | 2015-05-22 |
| 1942690136 | Christopher S. Lee, Md, Mba, Inc. | Specialist | 191 S Buena Vista St, Suite 470, Burbank, CA 91505-4554 | 2015-01-27 |
| 1285036640 | Petros Hajian | Family Medicine | 191 S Buena Vista St, Suite 220, Burbank, CA 91505-4554 | 2014-09-17 |
| 1639579105 | Armine Ghazaryan Md Inc | Obstetrics & Gynecology | 191 S Buena Vista St, Suite 300, Burbank, CA 91505-4554 | 2014-09-03 |
| 1326478777 | Leslie Korostoff Md A Professional Corporation | Obstetrics & Gynecology | 191 S Buena Vista St, Suite 340, Burbank, CA 91505-4554 | 2013-11-22 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023625035 | K and S Hospice Inc | Hospice Care, Community Based | 4100 W Alameda Ave Fl 3, Burbank, CA 91505 | 2020-09-24 |
| 1013542471 | Jami Stehlin | Nurse Practitioner | 501 S. Buena Vista St. 3ne, Burbank, CA 91505 | 2020-03-06 |
| 1497309033 | Ibrahim Lala | Pharmacist | 181 S. Buena Vista St, Burbank, CA 91505 | 2019-08-01 |
| 1720501240 | Jung H Li | Registered Nurse | Psjmc- Bariatric Wellness Center, 501 S Buena Vista St, Burbank, CA 91505 | 2017-07-18 |
| 1699204974 | Beth Ellen Izbotsky | Physical Medicine & Rehabilitation | 501 S Buena Vista Blvd, Burbank, CA 91505 | 2017-06-08 |
| 1205387446 | Fabiola Bachman | Dentist | 138 N Pass Ave, 2, Burbank, CA 91505 | 2016-10-24 |
| 1114478203 | Marianna Ghularyan D.d.s. Inc | Dentist | 1400 N. Edison Blvd., Burbank, CA 91505 | 2016-10-24 |
| 1962952127 | Landa Mizin Dental Partnership | Dentist | 2625 W Alameda Ave Ste 502, Burbank, CA 91505 | 2016-10-11 |
| 1285183376 | Amy Di Francia | Marriage & Family Therapist | 4421 W Riverside Dr Ste 210, Burbank, CA 91505 | 2016-09-29 |
| 1306238381 | Abigail Merrin | Physical Therapist | 2701 W Alameda Ave Ste 206, Burbank, CA 91505 | 2015-02-26 |
| Find all providers in zip 91505 | ||||
| Taxonomy Code | 207V00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Obstetrics & Gynecology |
| An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Obstetrics and Gynecology, 2007. http://www.abog.org/. American Osteopathic Board of Obstetrics and Gynecology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Obstetrics and Gynecology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Obstetrics and Gynecology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750866679 | Her Wellness, Inc. | Obstetrics & Gynecology | 191 S Buena Vista St Ste 340, Burbank, CA 91505-4562 | 2018-09-26 |
| 1245610088 | Lucineh Cristina Parsanian | Obstetrics & Gynecology | 2601 W Alameda Ave Ste 412, Burbank, CA 91505-4813 | 2015-06-07 |
| 1043562911 | Healthy Woman, Inc | Obstetrics & Gynecology | 191 South Buena Vista Street, #340-30, Burbank, CA 91505-4562 | 2012-10-02 |
| 1487880506 | Vardui Asiryan | Obstetrics & Gynecology | 1411 W Olive Ave Ste D, Burbank, CA 91506-2400 | 2009-06-03 |
| 1871742981 | Armine Ghazaryan | Obstetrics & Gynecology | 191 S Buena Vista St Ste 300, Burbank, CA 91505-4556 | 2008-09-12 |
| 1710151675 | Brady Jill Reis | Obstetrics & Gynecology | 4901 W. 79th St, Suite 10, Burbank, IL 60459-1554 | 2008-04-22 |
| 1316085988 | Buena Vista Woman's Comprehensive Care Medical Associates | Obstetrics & Gynecology | 2701 W Alameda Ave Ste 604, Burbank, CA 91505-4411 | 2007-02-03 |
| 1740374396 | Mehmet Kasim | Obstetrics & Gynecology | 1508-1510 W. Verdugo Ave, Burbank, CA 91506 | 2006-10-03 |
| 1952407975 | Verdugo Medical Group, Inc | Obstetrics & Gynecology | 1508 W Verdugo Ave Ste C, Burbank, CA 91506-2446 | 2006-09-16 |
| 1790796753 | Richard Bardowell | Obstetrics & Gynecology | 500 E Olive Ave Ste 420, Burbank, CA 91501-2171 | 2006-08-11 |
| Find all providers in BURBANK | ||||
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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.