| Lakeside Community Healthcare Medical Group | |
|
607 S Glenoaks Blvd Burbank CA 91502-1424 | |
| (818) 557-2671 | |
| (818) 557-0761 |
| Full Name | Lakeside Community Healthcare Medical Group |
|---|---|
| Speciality | Family Medicine |
| Location | 607 S Glenoaks Blvd, Burbank, California |
| Authorized Official Name and Position | Kerry E. Weiner (PRESIDENT) |
| Authorized Official Contact | 8186372000 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lakeside Community Healthcare Medical Group 777 Flower St Suite A Glendale CA 91201-3015 Ph: (818) 637-2000 | Lakeside Community Healthcare Medical Group 607 S Glenoaks Blvd Burbank CA 91502-1424 Ph: (818) 557-2671 |
| NPI Number | 1043256027 |
|---|---|
| Provider Enumeration Date | 06/20/2006 |
| Last Update Date | 05/12/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1043256027 | NPI | - | NPPES |
| GR0068382 | Medicaid | CA |
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