Graduated: 2021
NPI: 1205677523
Practice Locations (3)
LAKESIDE MEDICAL ORGANIZATION A MEDICAL GROUP INC
191 S BUENA VISTA ST, SUITE 150
BURBANK, CA 915054522
8182955920
NORTHRIDGE, CA 91324
8186832511
20046 BETZ DR
WINNETKA, CA 913061107
Source: CMS National Downloadable File, September 2026.