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 1205002862

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

In the registry since
2008
Specialties on file
4
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

1510 S Central Ave Ste 300
Glendale, CA 91204-2500
Phone: (818) 254-1511
Fax: (818) 254-1500
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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
Gastroenterology Physician Taxonomy 207RG0100X
General Practice Physician Taxonomy 208D00000X

Record details

NPI number1205002862
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Kerry Weiner — President · (818) 637-2000
Other names Lakeside Community Healthcare Medical Group
NPI enumeratedMay 5, 2008
Last updated in NPPESMay 11, 2009
Mailing address777 Flower Street, Suite A, Glendale, CA 91201-3000

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