LAKESIDE COMMUNITY HEALTHCARE MEDICAL GROUP
NPI 1689869760
Dermatology in N Hollywood, CA
NPI Status: Active since September 11, 2007
Contact Information
12660 RIVERSIDE DR
SUITE 225
N HOLLYWOOD, CA
ZIP 91607
Phone: (818) 755-0265
Fax: (818) 753-9074
- Organization
- Dermatology
- CLIA Number: 05D1019485
- CLIA Cert. Type: Physician Office
- CLIA Exp. Date: 11-18-2025
About LAKESIDE COMMUNITY HEALTHCARE MEDICAL GROUP
This page provides the complete NPI Profile along with additional information for Lakeside Community Healthcare Medical Group, a provider established in N Hollywood, California operating as a Dermatology. The healthcare provider is registered in the NPI registry with number 1689869760 assigned on September 2007. The practitioner's primary taxonomy code is 207N00000X. The provider is registered as an organization and their NPI record was last updated 16 years ago. Lakeside Community Healthcare Medical Group operates as a multi-specialty business group with one or more individual providers who practice different areas of specialization. The provider's is doing business as Lakeside Community Healthcare Medical Group. The authorized official of this NPI record is Kerry E. Weiner M.d. (President)
- NPI
- 1689869760
- Provider Legal Name
- LAKESIDE MEDICAL ASSOCIATES, A MEDICAL GROUP, INC.
- Other Organization Name
- LAKESIDE COMMUNITY HEALTHCARE MEDICAL GROUP
- Other Name Type
- Doing Business As (3)
- Entity Type
- Organization
- Location Address
- 12660 RIVERSIDE DR SUITE 225 N HOLLYWOOD, CA 91607
- Location Phone
- (818) 755-0265
- Location Fax
- (818) 753-9074
- Mailing Address
- 777 FLOWER ST STE A GLENDALE, CA 91201
- Mailing Phone
- (818) 637-2000
- Mailing Fax
- (818) 753-9074
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 09-11-2007
- Last Update Date
- 05-06-2009
- Code Navigator
A dermatologist like Lakeside Community Healthcare Medical Group is a medical specialty involving the management of skin conditions and diseases. Dermatologists diagnose some sexually transmitted diseases, warts, cancer, acne, dermatitis and may offer cosmetic treatments, and therapies that reduce age spots and wrinkles.
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Dermatology
- Taxonomy Code
- 207N00000X
- Type
- Allopathic & Osteopathic Physicians
- Taxonomy Description
- A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging.
Secondary Taxonomies
The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.
| No. | Taxonomy Code | Type | Classification / Specialization |
License No. (State) |
|---|---|---|---|---|
| 1 | 207Q00000X | Allopathic & Osteopathic Physicians | Family Medicine |
Group Taxonomy 193200000X MULTI-SPECIALTY GROUP
This provider is a business group of one or more individual practitioners, who practice with different areas of specialization.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| W12279 | MEDICARE PIN (08) | CA | |
| GR0068384 | MEDICAID (05) | CA | |
| W12279G | MEDICARE PIN (08) | CA |
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 05D1019485
- Facility Type
- Physician Office
- Certificate Effective Date
- November 19, 2023
- Certificate Expiration Date
- November 18, 2025
- Laboratory Director
- ELENA KANDEL
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to Lakeside Community Healthcare Medical Group to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.
Reviews for LAKESIDE COMMUNITY HEALTHCARE MEDICAL GROUP
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NPI Validation Check Digit Calculation
The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.
| Start with the original NPI number, the last digit is the check digit and is not used in the calculation. | |||||||||
| 1 | 6 | 8 | 9 | 8 | 6 | 9 | 7 | 6 | 0 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 6 | 16 | 9 | 16 | 6 | 18 | 7 | 12 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 6 + 1 + 6 + 9 + 1 + 6 + 6 + 1 + 8 + 7 + 1 + 2 + 24 = 80 | |||||||||
| Step 3: because the number obtained in step 2 ends in zero, the check digit is zero. | |||||||||
| 0 | |||||||||
The NPI number 1689869760 is valid because the calculated check digit 0 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the Same Location
The following 20 providers are registered at the same or nearby location.
| NPI | Name / Type | Taxonomy | Address |
|---|---|---|---|
| 1235131343 | DR. ERIC J PINDERSKI M.D. Individual | Internal Medicine | 12660 RIVERSIDE DR STE 310 N HOLLYWOOD, CA 91607 (818) 755-0391 |
| 1619975158 | LAKESIDE MEDICAL ASSOCIATES, A MEDICAL GROUP, INC. Organization | Family Medicine | 12660 RIVERSIDE DR SUITE 310/320 NORTH HOLLYWOOD, CA 91607 (818) 755-0391 |
| 1316921075 | SEAN JOSEPH WOLLASTON M.D. Individual | Specialist | 12660 RIVERSIDE DR SUITE 200 NORTH HOLLYWOOD, CA 91607 (818) 980-7010 |
| 1104801463 | DR. PENG THIM FAN M.D. Individual | Specialist | 12660 RIVERSIDE DR NORTH HOLLYWOOD, CA 91607 (818) 980-7010 |
| 1053391185 | NOHA R BARSOUM M.D. Individual | Internal Medicine | 12660 RIVERSIDE DR SUITE 225 NORTH HOLLYWOOD, CA 91607 (818) 487-0040 |
| 1366452112 | STEVEN ZLATT, M.D. INC. Organization | Anesthesiology | 12660 RIVERSIDE DR STE 300 STUDIO CITY, CA 91607 (818) 623-5310 |
| 1770693095 | DR. PAZRICA M. CHO I M.D. Individual | Internal Medicine | 12660 RIVERSIDE DR SUITE 110 VALLEY VILLAGE, CA 91607 (818) 761-1800 |
| 1972695369 | ANNA ROSEMARY SAUNDERS Individual | Physical Therapist | 12660 RIVERSIDE DR 215 VALLEY VILLAGE, CA 91607 (818) 506-7821 |
| 1669519450 | ANGELICA ANG DDS Individual | Dentist (General Practice) | 12660 RIVERSIDE DR SUITE 330 NORTH HOLLYWOOD, CA 91607 (818) 980-2647 |
| 1578607883 | PATRICIA A WILKIE D.C. Individual | Chiropractor | 12660 RIVERSIDE DR SUITE 210 VALLEY VILLAGE, CA 91607 (818) 755-0644 |
| 1912103680 | LAUREN MICHELLE PAPA D.C. Individual | Chiropractor | 12660 RIVERSIDE DR 201 VALLEY VILLAGE, CA 91607 (818) 769-2101 |
| 1225208606 | RHEUMATOLOGY ASSOCIATES Organization | Internal Medicine (Rheumatology) | 12660 RIVERSIDE DR SUITE 200 NORTH HOLLYWOOD, CA 91607 (818) 980-7010 |
| 1629235239 | ANGELICA Y ANG, DDS INC Organization | Clinic/Center (Dental) | 12660 RIVERSIDE DR SUITE 330 NORTH HOLLYWOOD, CA 91607 (818) 980-2647 |
| 1750549291 | GINA DEEB D.D.S., A PROFESSIONAL DENTAL CORPORATION Organization | Dentist (Endodontics) | 12660 RIVERSIDE DR SUITE 240 VALLEY VILLAGE, CA 91607 (818) 760-8966 |
| 1801049861 | MS. YOLANDE MICHELLE MAVITY MPT Individual | Physical Therapist | 12660 RIVERSIDE DR STE. 215 VALLEY VILLAGE, CA 91607 (818) 506-7821 |
| 1174767859 | PROF. RACHEL CHEN L.AC. Individual | Acupuncturist | 12660 RIVERSIDE DR SUITE 325 VALLEY VILLAGE, CA 91607 (818) 807-4372 |
| 1073827648 | ORTHOPEDIC REHABILITATION ASSOCIATES OF SAN FERNANDO VALLEY Organization | Legal Medicine | 12660 RIVERSIDE DR SUITE 201 NORTH HOLLYWOOD, CA 91607 (818) 769-2101 |
| 1396024642 | PHYSICAL THERAPY FOR SPECIALTY CARE Organization | Physical Therapist | 12660 RIVERSIDE DR #215 VALLEY VILLAGE, CA 91607 (818) 308-8747 |
| 1558648444 | NATIONWIDE INTERPRETING, INC Organization | Interpreter | 12660 RIVERSIDE DR 205 NORTH HOLLYWOOD, CA 91607 (323) 556-3470 |
| 1740224021 | YAROSLAV A GOFNUNG MD Individual | Internal Medicine (Endocrinology, Diabetes & Metabolism) | 12660 RIVERSIDE DR SUITE 225 NORTH HOLLYWOOD, CA 91607 (818) 487-0040 |
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1689869760, enumerated in the NPI registry as an "organization" on September 11, 2007
The provider is located at 12660 Riverside Dr Suite 225 N Hollywood, Ca 91607 and the phone number is (818) 755-0265
This medical organization specializes in Dermatology with taxonomy code 207N00000X
The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.
The provider's CLIA number is 05D1019485 for a "physician office" facility with a CLIA Certificate of Waiver. This CLIA certificate is issued to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria..
This NPI record was last updated on September 11, 2007. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
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