| NPI | 1215973292 |
|---|---|
| Doing Business As | LAKESIDE COMMUNITY HEALTHCARE MEDICAL GROUP |
| Entity Type | Organization |
| Authorized Contact | KERRY E. WEINER President 818-637-2000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 207N00000X Dermatology |
| 207R00000X Internal Medicine | |
| 207RR0500X Internal Medicine, Rheumatology | |
| 213EP1101X Podiatrist, Primary Podiatric Medicine | |
| 208600000X Surgery | |
| 208D00000X General Practice | |
| 208000000X Pediatrics | |
| 363L00000X Nurse Practitioner | |
| Enumeration Date | 2006-06-20 |
| Last Update Date | 2009-05-12 |