DR. LISA A BROCKMAN (NPI# 1063417798) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1063417798 |
| Entity Type | Individual |
| Full Name | DR. LISA A BROCKMAN |
| Credential | DO |
| Practice Address |
3820 Martin Luther King Jr Blvd Lynwood CA 90262-3625 |
| Practice Telephone | 3106320415 |
| Practice Fax Number | 3106392734 |
| Mailing Telephone | 3106320415 |
| Mailing Fax Number | 3106392734 |
| Enumeration Date | 2005-06-17 |
| Last Update Date | 2012-09-17 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207R00000X | Internal Medicine | 20A8065 | CA | Allopathic & Osteopathic Physicians |
| N | 208M00000X | Hospitalist | 20A806 | CA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | MEDI CAL # | 002A80650 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891023099 | Lisa Michele Brockman | Pharmacist | 6302 Fairmont Pkwy, Pasadena, TX 77505-4219 | 2009-11-27 |
| Street Address |
3820 MARTIN LUTHER KING JR BLVD |
| City | LYNWOOD |
| State | CA |
| Zip Code | 90262-3625 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275132839 | Claire Anne Vasquez | Registered Nurse | 3820 Martin Luther King Jr Blvd, Lynwood, CA 90262-3625 | 2020-10-23 |
| 1295347276 | Beatriz Borjas | Case Manager/Care Coordinator | 3820 Martin Luther King Jr Blvd, Lynwood, CA 90262-3625 | 2020-08-20 |
| 1629696422 | Jacqueline Lara | Case Manager/Care Coordinator | 3820 Martin Luther King Jr Blvd, Lynwood, CA 90262-3625 | 2020-07-08 |
| 1457977530 | Elise Boretz | Dietitian, Registered | 3820 Martin Luther King Jr Blvd, Lynwood, CA 90262-3625 | 2020-06-24 |
| 1538784806 | Rosa Lemus | Registered Nurse | 3820 Martin Luther King Jr Blvd, Lynwood, CA 90262-3625 | 2020-06-12 |
| 1861021206 | Brenda Martin | Case Manager/Care Coordinator | 3820 Martin Luther King Jr Blvd, Lynwood, CA 90262-3625 | 2020-04-07 |
| 1578197802 | Jorge Serrano | Licensed Vocational Nurse | 3820 Martin Luther King Jr Blvd, Lynwood, CA 90262-3625 | 2020-02-25 |
| 1356988414 | Belen Gonzalez | Licensed Vocational Nurse | 3820 Martin Luther King Jr Blvd, Lynwood, CA 90262-3625 | 2019-12-06 |
| 1659917912 | Carla Solis | Registered Nurse | 3820 Martin Luther King Jr Blvd, Lynwood, CA 90262-3625 | 2019-11-21 |
| 1124669791 | Joshela Clark | Occupational Therapist | 3820 Martin Luther King Jr Blvd, Lynwood, CA 90262-3625 | 2019-10-03 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811546062 | Sheila Maxine Wilkins | Technician | 3940 Palm Ave, Lynwood, CA 90262 | 2019-09-10 |
| 1891344669 | Chezoma Latissue Davis | Technician | 4255 Niland St, Lynwood, CA 90262 | 2019-09-05 |
| 1295223345 | Scla Comprehensive Surgical Medical Group, Inc. | Clinic/Center | 3628 E Imperial Hwy Ste 204, Lynwood, CA 90262 | 2018-04-24 |
| 1891213807 | Grecia Veronica Nunez | Case Manager/Care Coordinator | 3680 E. Imperial Highway, Suite 200, Lynwood, CA 90262 | 2017-08-30 |
| 1134643448 | Angelica Jazmin Alonso Cortes | Case Manager/Care Coordinator | 2610 Industry Way Suite A, Lynwood, CA 90262 | 2017-07-28 |
| 1134594997 | Corinne Palma | Counselor | 11705 S. Alameda St., Lynwood, CA 90262 | 2015-12-04 |
| 1891175550 | Nancy Bremmer | Counselor | 10705 S. Alameda Street, Los Angels, CA 90262 | 2015-06-08 |
| 1588041347 | Jennifer Montoya | Case Management | 5433 E. Pelleur St., Lynwood, CA 90262 | 2015-04-30 |
| 1124440060 | Susana Gyek Goy | Chiropractor | 11123 Long Beach Blvd. Suite 5, Lynwood Health Center, Lynwood, CA 90262 | 2014-01-13 |
| 1215368956 | Baart Community Healthcare | Clinic/Center | 11315 S. Atlantic Blvd., Lynwood, CA 90262 | 2013-12-05 |
| Find all providers in zip 90262 | ||||
| Taxonomy Code | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669661492 | Odette R Tawadrous | Internal Medicine | 3625 Martin Luther King Jr Blvd Ste 10, Lynwood, CA 90262-3509 | 2007-10-17 |
| 1902008014 | Edward Alan Ridgill | Internal Medicine | 3625 E. Martin Luther King Jr. Bl., Suite 9, Lynwood, CA 90262 | 2007-06-01 |
| 1306981196 | Diana Echeverry-franck | Internal Medicine | 3621 Martin Luther King Jr Blvd Suite 1, Lynwood, CA 90262 | 2007-02-20 |
| 1619036621 | Alva A Marsh | Internal Medicine | 3591 E Imperial Hwy, Ste 1, Lynwood, CA 90262 | 2006-12-06 |
| 1356414262 | Nijole Glaze | Internal Medicine | 3737 Martin Luther King Jr Blvd Ste 404, Lynwood, CA 90262-3534 | 2006-11-16 |
| 1326052689 | Lynwood United Medical Corporation | Internal Medicine | 3150 E Imperial Hwy, Suite 203, Lynwood, CA 90262-3223 | 2006-07-29 |
| 1821002874 | Beverly C Davis | Internal Medicine | 3628 Imperial Hwy, 202, Lynwood, CA 90262-2600 | 2006-07-27 |
| 1104823814 | Ricardo Enrique Mckenzie | Internal Medicine | 3680 E Imperial Hwy, Suite 470, Lynwood, CA 90262-2659 | 2005-07-07 |
| 1407473903 | Los Angeles County Multi-specialty Medical Group Inc | Internal Medicine | 3628 E Imperial Hwy Ste 300, Lynwood, CA 90262-2646 | 2020-06-30 |
| 1558717165 | Odette R Tawadrous Medical Clinic Inc. | Internal Medicine | 3625 Martin Luther King Jr Blvd Ste 10, Lynwood, CA 90262-3509 | 2016-05-12 |
| Find all providers in LYNWOOD | ||||
Please comment or provide details below to improve the information on DR. LISA A BROCKMAN.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.