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JEROME P. LISK M.D. INC. NPI 1598952616


NPI Information

NPI: 1598952616
Provider Name: JEROME P. LISK, M.D., INC.

Doing Business As: SOUTHERN CALIFORNIA MOVEMENT DISORDER SEPCIALISTS

Classification: Psychiatry & Neurology - 2084N0400X
Entity Type: Organization

Specialization: Neurology

Address:
65 N MADISON AVE
SUITE 410
PASADENA, CA
ZIP 91101
Phone: (626) 792-6683
Get Directions

JEROME P. LISK, M.D., INC. is a neurology psychiatry neurology in Pasadena, CA. The provider is 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. JEROME P. LISK, M.D., INC. NPI is 1598952616. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Southern California Movement Disorder Sepcialists.

The provider's business location address is:

65 N MADISON AVE
SUITE 410
PASADENA, CA
ZIP 91101-035
Phone: (626) 792-6683
Fax: (626) 793-5475

The provider's authorized official is Jerome P Lisk .
The authorized official title is Physician and has the following contact phone number (940) 383-1770.

The enumeration date for this NPI number is 10/2/2007 and was last updated on 3/29/2021.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
12084N0400XPsychiatry & NeurologyNeurologyA88331CALIFORNIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1DQ9581OTHERCALIFORNIAMEDICARE RAILROAD

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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