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 1619975158

Lakeside Medical Associates, a Medical Group, Inc is a Family Medicine Physician in North Hollywood, California. Licensed in California. Registered with an NPI since 2005.

Licensed in
CA
In the registry since
2005
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

12660 Riverside Dr Ste 310/320
North Hollywood, CA 91607-3429
Phone: (818) 755-0391
Fax: (818) 753-8165
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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 (CA)
Internal Medicine Physician Taxonomy 207R00000X (CA)
Pediatrics Physician Taxonomy 208000000X (CA)
Nurse Practitioner Taxonomy 363L00000X (CA)

Record details

NPI number1619975158
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Kerry Weiner — President · (818) 637-2000
Other names Lakeside Community Healthcare Medical Group
NPI enumeratedJuly 8, 2005
Last updated in NPPESMay 6, 2009
Mailing address777 Flower St, Suite A, Glendale, CA 91201-3015

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