Lakeside Medical Associates, a Medical Group, Inc.

NPI #1689869760 in N Hollywood, California

Provider Information

NPI Number: 1689869760
Entity Type: Organization
Organization Name: Lakeside Medical Associates, a Medical Group, Inc.
Primary Specialty: Dermatology
Enumeration Date: Sep 11, 2007
Last Updated: May 6, 2009

Practice Location

Address: 12660 RIVERSIDE DR
Address 2: SUITE 225
City: N Hollywood
State: California
ZIP Code: 91607-3429
Phone: (818) 755-0265

Authorized Official

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

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Family Medicine	207Q00000X
Dermatology	207N00000X	Primary

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