| NPI | 1487859815 |
|---|---|
| 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 | 208800000X Urology |
| Enumeration Date | 2007-06-16 |
| Last Update Date | 2009-05-06 |