DR. LISA KELLMAN (NPI# 1821164690) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1821164690 |
| Entity Type | Individual |
| Full Name | DR. LISA KELLMAN |
| Credential | D.O. |
| Practice Address |
4560 Admiralty Way Ste 100 Marina Del Rey CA 90292-5424 |
| Mailing Address |
5767 W Century Blvd Ste 400 Los Angeles CA 90045-5631 |
| Practice Telephone | 3106561770 |
| Mailing Telephone | (310) 301-8707 |
| Mailing Fax Number | 3103018751 |
| Enumeration Date | 2006-11-25 |
| Last Update Date | 2018-03-17 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207P00000X | Emergency Medicine | 20A5062 | CA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | 00AX50620 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 100 S Raymond Ave, Alhambra, CA 918013166 | 6268363020 | 6268362920 |
| Street Address |
4560 ADMIRALTY WAY STE 100 |
| City | MARINA DEL REY |
| State | CA |
| Zip Code | 90292-5424 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548258064 | Arti H Chawla | Internal Medicine | 4560 Admiralty Way Ste 100, Marina Del Rey, CA 90292-5424 | 2005-10-10 |
| 1851772214 | Salim F Ahmed | Internal Medicine | 4560 Admiralty Way Ste 100, Marina Del Rey, CA 90292-5424 | 2015-06-11 |
| 1528471174 | Madeleine Vonderschmidt | Physician Assistant | 4560 Admiralty Way Ste 100, Marina Del Rey, CA 90292-5424 | 2014-06-10 |
| 1003104548 | Cathia Vazquez | Family Medicine | 4560 Admiralty Way Ste 100, Marina Del Rey, CA 90292 | 2011-07-19 |
| 1326072380 | Riquaza Zainul Zavahir | Internal Medicine | 4560 Admiralty Way Ste 100, Marina Del Rey, CA 90292-5424 | 2006-07-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972142420 | Katy Kleinberg | Physical Therapist | 4820 Lincoln Blvd., Marina Del Rey, CA 90292 | 2020-01-02 |
| 1568028330 | Kylie Nakamine | Physical Therapist | 4820 Lincoln Bld, Marina Del Rey, CA 90292 | 2019-05-16 |
| 1033627807 | Kareema Nasouf | Social Worker | 578 Washington Blvd. #815, Marina Del Rey, CA 90292 | 2018-01-16 |
| 1861916611 | Jaqueline Berenice Higbee | Behavior Technician | 13428 Maxella Ave Apt 913, Marina Del Rey, CA 90292 | 2017-08-02 |
| 1063942696 | Luis Albert Japngie | Chiropractor | 13816 Bora Bora Way, A-109, Marina Del Rey, CA 90292 | 2017-06-15 |
| 1427509082 | Melissa Dowling | Nurse Anesthetist, Certified Registered | 4750 Lincoln Blvd Apt 477, Marina Del Rey, CA 90292 | 2016-10-19 |
| 1578932950 | Gratto Aquatic Rehab | Clinic/Center | 13160 Mindanao Way Ste. 308, Marina Del Ray, CA 90292 | 2015-09-16 |
| 1285018309 | Reed Chiropractic & Wellness Center A Professional Corporation | Chiropractor | 4207 Del Rey Ave., Marina Del Rey, CA 90292 | 2015-07-18 |
| 1083990725 | James J Kim | Pharmacist | 4009 Lincoln Blvd., Walgreens, Marina Del Rey, CA 90292 | 2011-10-26 |
| 1689957805 | Medbil, LLC | Anesthesiology | 1024 Oxford Ave., Marina Del Rey, CA 90292 | 2011-09-23 |
| Find all providers in zip 90292 | ||||
| Taxonomy Code | 207P00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Emergency Medicine |
| An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: mofified source] - Additional Resources: American Board of Emergency Medicine, 2007. http://www.abem.org/public/; American Osteopathic Board of Emergency Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Emergency Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Emergency Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730440025 | Thomas Edward Blair | Emergency Medicine | 14020 Old Harbor Ln Apt 203, Marina Del Rey, CA 90292-7309 | 2012-06-03 |
| 1659535797 | Niloufar Naima | Emergency Medicine | 310 Tahiti Way Apt 201, Marina Del Rey, CA 90292-6743 | 2008-07-17 |
| 1730197062 | Jawchyi Lee | Emergency Medicine | 13428 Maxella Avenue #759, Marina Del Rey, CA 90292-6090 | 2006-08-03 |
| 1164461752 | David I. Friend | Emergency Medicine | 4551 Glencoe Ave, Suite 260, Marina Del Rey, CA 90292-6385 | 2006-06-06 |
| 1811941701 | Richard Jay Hoffner | Emergency Medicine | 4650 Lincoln Boulevard, Marina Del Rey, CA 90292 | 2006-05-22 |
| 1154734663 | Petrel Emergency Physicians, A Medical Corporation | Emergency Medicine | 4650 Lincoln Blvd, Marina Del Rey, CA 90292-6306 | 2014-06-03 |
| 1801010152 | Robert D Slay | Emergency Medicine | 4650 Lincoln Blvd, Marina Del Rey, CA 90292-6306 | 2007-04-11 |
| 1659403228 | Kirsten Elizabeth Mewaldt | Emergency Medicine | 4650 Lincoln Blvd, Unit #1604, Marina Del Rey, CA 90292-6306 | 2007-03-09 |
| 1750464707 | Mickey M Kolodny | Emergency Medicine | 4650 Lincoln Blvd, Marina Del Rey, CA 90292 | 2006-10-23 |
| 1346332293 | Rosanne Kay | Emergency Medicine | 4650 Lincoln Blvd, Marina Del Rey, CA 90292 | 2006-09-29 |
| Find all providers in MARINA DEL REY | ||||
| City | MARINA DEL REY |
| Zip Code | 90292 |
Please comment or provide details below to improve the information on DR. LISA KELLMAN.
| 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.