LAKESIDE COMMUNITY HEALTHCARE MEDICAL GROUP – NPI #1104001288
Internal Medicine

An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms.

Health Care Provider Taxonomy Code for Internal Medicine

LAKESIDE COMMUNITY HEALTHCARE MEDICAL GROUP is a provider located in GLENDALE, CA. NPPES has assigned the NPI number 1104001288 to LAKESIDE COMMUNITY HEALTHCARE MEDICAL GROUP on January 08, 2008. It is a Type-2 NPI, indicating this NPI number is associated with an organization. Since the name “LAKESIDE COMMUNITY HEALTHCARE MEDICAL GROUP” is a dba name, the actual legal business name for this organization is LAKESIDE MEDICAL ASSOCIATES, A MEDICAL GROUP, INC.. The primary taxonomy selected by this provider is 207RC0000X from the Health Care Provider Taxonomy code set, which is classified as Internal Medicine, specializing in Cardiovascular Disease

The NPI profile was previously updated about 17 years ago on May 11, 2009. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for LAKESIDE COMMUNITY HEALTHCARE MEDICAL GROUP below.

NPI Profile for
LAKESIDE MEDICAL ASSOCIATES, A MEDICAL GROUP, INC.

NPI Number
1104001288
Enumeration Date

(more than 18 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
LAKESIDE MEDICAL ASSOCIATES, A MEDICAL GROUP, INC.
Doing Business As (dba): LAKESIDE COMMUNITY HEALTHCARE MEDICAL GROUP
Primary location
1500 S CENTRAL AVE
SUITE 320
GLENDALE, CA 91204-2530
Phone: (818) 247-3708 Fax: (818) 547-3146
Mailing address
777 FLOWER ST
SUITE A
GLENDALE, CA 91201-3015
Phone: (818) 637-2000 Fax: (818) 242-8761
Organization Subpart
No
Authorized Official
KERRY WEINER
PRESIDENT
Phone: (818) 637-2000
Updated
Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
207RC0000X
- Internal Medicine / Cardiovascular Disease (Primary)

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.