Graduated: 2021
NPI: 1629645635
Practice Locations (2)
LAKESIDE MEDICAL ORGANIZATION A MEDICAL GROUP INC
191 S BUENA VISTA ST, SUITE 200 AND 240
BURBANK, CA 915054542
8188872671
LAKESIDE MEDICAL ORGANIZATION A MEDICAL GROUP INC
12660 RIVERSIDE DR, SUITE 225
NORTH HOLLYWOOD, CA 916073469
8187550265
Source: CMS National Downloadable File, September 2026.