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LAKESIDE COMMUNITY HEALTHCARE MEDICAL GROUP
NPI 1619975158
Family Medicine in North Hollywood, CA

Active since July 08, 2005CLIA 05D0952072 · Waiver
12660 RIVERSIDE DR, SUITE 310/320, NORTH HOLLYWOOD, CA 91607(818) 755-0391(818) 753-8165 Get Directions Write a Review

NPPES record last updated: May 6, 2009. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Lakeside Community Healthcare Medical Group NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

LAKESIDE COMMUNITY HEALTHCARE MEDICAL GROUP (NPI 1619975158) is a healthcare organization registered as a family medicine in North Hollywood, California and active in the NPI registry since July 2005. The organization holds a CLIA Waiver certificate valid through October 1, 2026 and lists Kerry E. Weiner, President, as its authorized official.

NPPES Registry Identity

NPI1619975158
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameLAKESIDE MEDICAL ASSOCIATES, A MEDICAL GROUP, INC.
Location Address12660 RIVERSIDE DR, SUITE 310/320North Hollywood, CA 91607-3429
Mailing Address777 Flower St, Suite AGlendale, CA 91201-3015 · (818) 637-2000 · Fax (818) 242-8761
Phone(818) 755-0391
Fax(818) 753-8165
Organization SubpartNo
Authorized OfficialKerry E. WeinerPresident · (818) 637-2000
Enumeration DateJuly 8, 2005
Last NPPES UpdateMay 6, 2009
✔ NPI 1619975158 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 4

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
Definition

Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

Also ListedInternal MedicineTaxonomy 207R00000X
Also ListedPediatricsTaxonomy 208000000X
Also ListedNurse PractitionerTaxonomy 363L00000X
12660 RIVERSIDE DR, North Hollywood, CA 91607
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Other Names 1

Doing Business AsLakeside Community Healthcare Medical Group

Other Identifiers 2

Medicare PINW12279CA
MedicaidGR0068380CA

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 05D0952072

Lakeside Medical Organization, A Medical Grp, Inc · N Hollywood, CA
Active · expires Oct 1, 2026
CLIA Number05D0952072
Laboratory TypePhysician Office
Certificate Effective DateOctober 2, 2024
Certificate Expiration DateOctober 1, 2026
Laboratory DirectorElena Kandel
Laboratory Phone(818) 755-0391
Laboratory LocationLakeside Medical Organization, A Medical Grp, Inc12660 Riverside Dr Ste 310/320, N Hollywood, CA 91607
CLIA data matches this NPI record on: Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. ERIC J PINDERSKI M.D.
Internal Medicine
12660 RIVERSIDE DR, STE 310
N HOLLYWOOD, CA 91607
Los Angeles County (818) 755-0391
SEAN JOSEPH WOLLASTON M.D.
Specialist
12660 RIVERSIDE DR, SUITE 200
NORTH HOLLYWOOD, CA 91607
Los Angeles County (818) 980-7010
DR. PENG THIM FAN M.D.
Specialist
12660 RIVERSIDE DR
NORTH HOLLYWOOD, CA 91607
Los Angeles County (818) 980-7010
NOHA R BARSOUM M.D.
Internal Medicine
12660 RIVERSIDE DR, SUITE 225
NORTH HOLLYWOOD, CA 91607
Los Angeles County (818) 487-0040
STEVEN ZLATT, M.D. INC.
Anesthesiology
12660 RIVERSIDE DR, STE 300
STUDIO CITY, CA 91607
Los Angeles County (818) 623-5310
DR. PAZRICA M. CHO I M.D.
Internal Medicine
12660 RIVERSIDE DR, SUITE 110
VALLEY VILLAGE, CA 91607
Los Angeles County (818) 761-1800
ANNA ROSEMARY SAUNDERS
Physical Therapist
12660 RIVERSIDE DR, 215
VALLEY VILLAGE, CA 91607
Los Angeles County (818) 506-7821
ANGELICA ANG DDS
Dentist (General Practice)
12660 RIVERSIDE DR, SUITE 330
NORTH HOLLYWOOD, CA 91607
Los Angeles County (818) 980-2647

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Lakeside Medical Associates, A Medical Group, Inc.'s NPI number?

The NPI number for Lakeside Medical Associates, A Medical Group, Inc. is 1619975158. It was assigned to this organization in the NPPES registry on July 8, 2005. The provider is doing business as Lakeside Community Healthcare Medical Group.

Where is Lakeside Medical Associates, A Medical Group, Inc. located?

Lakeside Medical Associates, A Medical Group, Inc. is located at 12660 Riverside Dr Suite 310/320, North Hollywood, CA 91607. The listed phone number is (818) 755-0391.

What is Lakeside Medical Associates, A Medical Group, Inc.'s specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Does Lakeside Medical Associates, A Medical Group, Inc. hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 05D0952072) is associated with this NPI, valid through October 1, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Lakeside Medical Associates, A Medical Group, Inc. was last updated on May 6, 2009. NPI Profile syncs with the weekly NPPES data releases published by CMS.