OrganizationActive
Lakeside Medical Associates a Medical Group Inc
NPI 1104087774 · Family Medicine Physician · Sherman Oaks, CA
Provider details
- NPI number
- 1104087774
- Entity type
- Organization
- Primary specialty
- Family Medicine PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Kerry Weiner, President(818) 637-2000
Specialties & taxonomies
Allopathic & Osteopathic Physicians
- Internal Medicine Physician207R00000X
Allopathic & Osteopathic Physicians
Profile Score
Detailed profile(87/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
18 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
4955 Van Nuys Blvd
Suite 308
Sherman Oaks, CA 91403-1811
Phone: (818) 907-5088
Fax: (818) 907-5891
Street-level locationGet directions
Mailing address
777 Flower Street
Glendale, CA 91201-3000
Other names (DBA / former)
- Doing business as
- Lakeside Community Healthcare Medical Group
Registry dates
- Enumerated
- 2008-06-17
- Last updated
- 2009-05-06
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.