| NPI | 1740516236 |
|---|---|
| Doing Business As | LAKESIDE COMMUNITY HEALTHCARE MEDICAL GROUP |
| Entity Type | Organization |
| Authorized Contact | KERRY WEINER President 818-637-2000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology |
| Enumeration Date | 2009-10-19 |
| Last Update Date | 2009-10-19 |