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 1104087774

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

In the registry since
2008
Specialties on file
2
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

4955 Van Nuys Blvd Ste 308
Sherman Oaks, CA 91403-1811
Phone: (818) 907-5088
Fax: (818) 907-5891
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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

Record details

NPI number1104087774
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Kerry Weiner — President · (818) 637-2000
Other names Lakeside Community Healthcare Medical Group
NPI enumeratedJune 17, 2008
Last updated in NPPESMay 6, 2009
Mailing address777 Flower Street, Suite A, Glendale, CA 91201-3000

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