| NPI | 1316953029 |
|---|---|
| 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 | 225100000X Physical Therapist |
| Enumeration Date | 2006-08-01 |
| Last Update Date | 2009-05-11 |