Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Lakeside Medical Associates, a Medical Group, Inc

Organization Family Medicine Physician · NPI 1083879969

Lakeside Medical Associates, a Medical Group, Inc is a Family Medicine Physician in Simi Valley, California. Registered with an NPI since 2008.

In the registry since
2008
Specialties on file
5
What do these letters mean?
Inc — Incorporated
A form of business registration, not a clinical qualification.

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Practice location Address checks out

3605 Alamo St Ste 100
Simi Valley, CA 93063-2186
Phone: (805) 522-6577
Fax: (805) 522-7030
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X
Internal Medicine Physician Taxonomy 207R00000X
Pediatrics Physician Taxonomy 208000000X
General Practice Physician Taxonomy 208D00000X
Physician Assistant Taxonomy 363A00000X

Record details

NPI number1083879969
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Kerry Weiner — President · (818) 637-2000
Other names Lakeside Community Healthcare Medical Group
NPI enumeratedJuly 21, 2008
Last updated in NPPESSeptember 4, 2009
Mailing address777 Flower Street, Suite A, Glendale, CA 91201-3000

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