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DR. RONALD DEMETRI LISKANICH D.O. NPI 1245391820


NPI Information

NPI: 1245391820
Provider Name: DR. RONALD DEMETRI LISKANICH, D.O.
Classification: Dermatology - 207NS0135X
Entity Type: Individual

Specialization: Procedural Dermatology

PECOS Registration: Yes

Address:
954 W FOOTHILL BLVD STE B
UPLAND, CA
ZIP 91786
Phone: (909) 949-7500
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DR. Ronald Demetri Liskanich, D.O. is a procedural dermatology dermatology in Upland, CA with 41 years of experience. The provider is procedural Dermatology, a subspecialty of Dermatology, encompassing a wide variety of surgical procedures and methods to remove or modify skin tissue for health or cosmetic benefit. These methods include scalpel surgery, laser surgery, chemical surgery, cryosurgery (liquid nitrogen), electrosurgery, aspiration surgery, liposuction, injection of filler substances, and Mohs micrographic controlled surgery (a special technique for the removal of growths, especially skin cancers). DR. Ronald Demetri Liskanich, D.O. NPI is 1245391820. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: KANSAS CITY UNIVERSITY OF MED & BIOSCIENCES, COLLEGE OF OSTEO MED
Graduation Year:1983

The provider's business location address is:

954 W FOOTHILL BLVD STE B
UPLAND, CA
ZIP 91786
Phone: (909) 949-7500
Fax: (909) 946-1133

The NPI 1245391820 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

  • Destruction of 2-14 skin growths (HCPCS:17003)
  • Destruction of skin growth (HCPCS:17000)
  • Biopsy of single growth of skin and/or tissue (HCPCS:11100)
  • Destruction of up to 14 skin growths (HCPCS:17110)
  • Biopsy of each additional growth of skin and/or tissue (HCPCS:11101)

The enumeration date for this NPI number is 12/13/2006 and was last updated on 10/18/2018.


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
1207NS0135XDermatologyProcedural Dermatology20A4952CALIFORNIAYes

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
100AX49520MEDICAIDCALIFORNIA
2020A49520OTHERCALIFORNIABLUE SHIELD

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: 11/14/2023

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.