LAKESIDE MEDICAL ASSOCIATES, A MEDICAL GROUP, INC.

WEST COVINA, CA
NPI1801051784
Entity TypeOrganization
Authorized ContactKERRY E. WEINER
President
818-637-2000
Organization Subpart ?No
Primary Taxonomy207Q00000X Family Medicine
Additional Taxonomies207R00000X Internal Medicine
207VG0400X Obstetrics & Gynecology Gynecology
208000000X Pediatrics
208600000X Surgery
207RG0100X Internal Medicine Gastroenterology
207N00000X Dermatology
363A00000X Physician Assistant
363LX0001X Nurse Practitioner Obstetrics & Gynecology
363L00000X Nurse Practitioner
Enumeration Date2008-07-21
Last Update Date2009-10-19
Business Address
LAKESIDE MEDICAL ASSOCIATES, A MEDICAL GROUP, INC.
1500 W WEST COVINA PKWY
WEST COVINA, CA 91790-2708
Phone number: 626-430-9991
Mailing Address
LAKESIDE MEDICAL ASSOCIATES, A MEDICAL GROUP, INC.
777 FLOWER STREET SUITE A
GLENDALE, CA 91201-3000
Phone number: 818-637-2000