JEROME P. LISK, M.D., INC. (NPI# 1598952616) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1598952616 |
| Entity Type | Organization |
| Organization Name | JEROME P. LISK, M.D., INC. |
| Other Organization Name | SOUTHERN CALIFORNIA MOVEMENT DISORDER SEPCIALISTS |
| Practice Address |
65 N Madison Ave Suite 410 Pasadena CA 91101-2035 |
| Practice Telephone | 6267926683 |
| Practice Fax Number | 6267935475 |
| Mailing Telephone | 6267926683 |
| Mailing Fax Number | 6267935475 |
| Enumeration Date | 2007-10-02 |
| Last Update Date | 2011-11-09 |
| Authorized Official Name | DR. JEROME P LISK (PHYSICIAN) |
| Authorized Official Telephone | 6267926683 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2084N0400X |
Psychiatry & Neurology Specialization: Neurology |
A88331 | CA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | MEDICARE RAILROAD | DQ9581 | 01 |
| Other Name | Type Code |
|---|---|
| Southern California Movement Disorder Sepcialists | Doing Business As Name - Organization |
| Street Address |
65 N MADISON AVE SUITE 410 |
| City | PASADENA |
| State | CA |
| Zip Code | 91101-2035 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427053693 | Bianca Grigorian | Internal Medicine | 65 N Madison Ave, Ste 800, Pasadena, CA 91101-2038 | 2005-06-15 |
| 1407308802 | Hilary Ruiz | Audiologist | 65 N Madison Ave, Suite #201, Pasadena, CA 91101-2035 | 2016-11-01 |
| 1790186112 | Mindful Pediatric Gastroenterology, Inc | Pediatrics | 65 N Madison Ave, Suite 709, Pasadena, CA 91101-2035 | 2014-09-05 |
| 1841607835 | Reach Wellness & Recovery Incorporated | Anesthesiology | 65 N Madison Ave, Suite 202, Pasadena, CA 91101-2035 | 2014-07-22 |
| 1356771315 | Ellen Miller Kwon, Psyd | Psychologist | 65 N Madison Ave, Suite 405, Pasadena, CA 91101-2035 | 2013-11-12 |
| 1396085635 | Eric Harlacher | Counselor | 65 N Madison Ave, Suite 302, Pasadena, CA 91101-2035 | 2013-02-24 |
| 1336483973 | Hillary Mastrosimone | Marriage & Family Therapist | 65 N Madison Ave, Suite 302, Pasadena, CA 91101-2035 | 2012-11-20 |
| 1750634192 | Cnc Pharmacy Inc | Pharmacy | 65 N Madison Ave, Pasadena, CA 91101 | 2012-10-23 |
| 1184976250 | James R. Esther,m.d.,inc | Dermatology | 65 N Madison Ave, Suite 409, Pasadena, CA 91101-2035 | 2012-10-12 |
| 1053680306 | Pacific Reproductive Services, Inc. | Nurse Practitioner | 65 N Madison Ave, Suite 610, Pasadena, CA 91101-2035 | 2011-12-15 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720696404 | Sophia Ting-jan Liang | Student in an Organized Health Care Education/Training Program | 98 S. Los Robles Ave., Kaiser Permanente Bernard J. Tyson School of Medicine, Pasdena, CA 91101 | 2020-07-17 |
| 1851917033 | Casa De Las Amigas | Lodging | 173 N Oak Knoll Ave, Pasadena, CA 91101 | 2020-06-23 |
| 1467076869 | Tong Qi | Student in an Organized Health Care Education/Training Program | Kaiser Permanente Bernard Kj. Tyson School of Medicine, Pasadena, CA 91101 | 2020-06-01 |
| 1386267839 | Kelly B Shriver | Student in an Organized Health Care Education/Training Program | Kaiser Permanente Bernard J. Tyson School of Medicine, 98 S. Los Robles, Pasadena, CA 91101 | 2020-05-19 |
| 1427600758 | Brooke Danielle Pechman | Marriage & Family Therapist | 221 E Walnut Street, Suite 138, Pasadena, CA 91101 | 2019-07-16 |
| 1952897563 | Robert Howes Hambleton | Dentist | 200 S. Oak Knoll Ave #201, Pasadena, CA 91101 | 2018-07-06 |
| 1801306774 | Joseph Hendrix | Social Worker | 1500 South Mcdonnell Avenue, Commerce, CA 91101 | 2017-10-05 |
| 1730606070 | Candice Anne Watson | Nurse Practitioner | 350 South Madison Ave #322, Pasadena, CA 91101 | 2017-08-28 |
| 1700320223 | Jenny H. Pak | Psychologist | 180 N. Oakland Ave., Pasadena, CA 91101 | 2016-12-19 |
| 1578005401 | James Maddox | Student in an Organized Health Care Education/Training Program | 447 El Molino Ave, Pasadena, CA 91101 | 2016-11-09 |
| Find all providers in zip 91101 | ||||
| Taxonomy Code | 2084N0400X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Neurology |
| A Neurologist specializes in the diagnosis and treatment of diseases or impaired function of the brain, spinal cord, peripheral nerves, muscles, autonomic nervous system, and blood vessels that relate to these structures. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427607647 | David A Girard A Medical Corporation | Psychiatry & Neurology | 50 Alessandro Pl Ste 120, Pasadena, CA 91105-4010 | 2019-09-10 |
| 1780189142 | Basewave Properties, Pllc | Psychiatry & Neurology | 4808 Fairmont Pkwy, #404, Pasadena, TX 77505 | 2018-03-28 |
| 1922339159 | Hugo V. Orellana, M.d.p.a. | Psychiatry & Neurology | 4014 Woodlawn Ave, Ste.a, Pasadena, TX 77504-1921 | 2010-01-28 |
| 1285862375 | Edward G. Barton | Psychiatry & Neurology | 630 S Raymond Ave Unit 310, Pasadena, CA 91105-3206 | 2009-06-26 |
| 1225226301 | Sharon Yegiaian | Psychiatry & Neurology | 139 S Los Robles Ave Unit B020, Pasadena, CA 91101-2488 | 2007-10-14 |
| 1932227063 | Mckinney Podiatric Associates Pa | Psychiatry & Neurology | 4102 Woodlawn Ave Ste 150b, Pasadena, TX 77504-1922 | 2007-03-27 |
| 1710012075 | Jai-hyon Rho, Md, Phd, A Medical Corp | Psychiatry & Neurology | 1555 Hillcrest Ave, Pasadena, CA 91106-4504 | 2007-02-23 |
| 1609815596 | Ali Moussaoui Md Pa | Psychiatry & Neurology | 3801 Vista Rd Ste 320, Pasadena, TX 77504-2139 | 2006-06-06 |
| 1366800443 | Sharon Yegiaian Md Inc | Psychiatry & Neurology | 139 S Los Robles Ave Unit B020, Pasadena, CA 91101-2488 | 2016-02-04 |
| 1093192486 | David A Valentine | Psychiatry & Neurology | 630 S Raymond Ave Unit 310, Pasadena, CA 91105-3206 | 2015-05-05 |
| Find all providers in PASADENA | ||||
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| 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.