Lakeside Medical Associates, a Medical Group, Inc.

NPI #1083879969 in Simi Valley, California

Provider Information

NPI Number: 1083879969
Entity Type: Organization
Organization Name: Lakeside Medical Associates, a Medical Group, Inc.
Primary Specialty: Family Medicine
Enumeration Date: Jul 21, 2008
Last Updated: Sep 4, 2009

Practice Location

Address: 3605 ALAMO ST
Address 2: SUITE 100
City: Simi Valley
State: California
ZIP Code: 93063-2186
Phone: (805) 522-6577

Authorized Official

Name: KERRY E. WEINER, M.D.
Title: PRESIDENT
Phone: (818) 637-2000

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Pediatrics	208000000X
Internal Medicine	207R00000X
Physician Assistant	363A00000X
General Practice	208D00000X
Family Medicine	207Q00000X	Primary

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