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 Dermatology Physician · NPI 1649475070

Lakeside Medical Associates, a Medical Group, Inc is a Dermatology Physician in Burbank, California. Registered with an NPI since 2007.

In the registry since
2007
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

191 S Buena Vista St 2nd Fl
Burbank, CA 91505-4504
Phone: (818) 524-2003
Fax: (818) 524-2807
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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
Dermatology Physician Taxonomy 207N00000X
Internal Medicine Physician Taxonomy 207R00000X
Endocrinology, Diabetes & Metabolism Physician Taxonomy 207RE0101X
Urology Physician Taxonomy 208800000X

Record details

NPI number1649475070
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Kerry Weiner — President · (818) 637-2000
Other names Lakeside Community Healthcare Medical Group
NPI enumeratedJune 16, 2007
Last updated in NPPESMay 11, 2009
Mailing address777 Flower St Ste A, Glendale, CA 91201-3000

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