LYSANDER JIM, M.D. INC (NPI# 1639619414) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1639619414 |
| Entity Type | Organization |
| Organization Name | LYSANDER JIM, M.D. INC |
| Practice Address |
452 N Altadena Dr Pasadena CA 91107-2536 |
| Mailing Address |
601 Camino Verde S Pasadena CA 91030-4139 |
| Practice Telephone | 6268003860 |
| Mailing Telephone | 6268003860 |
| Enumeration Date | 2017-02-27 |
| Last Update Date | 2017-02-27 |
| Authorized Official Name | DR. LYSANDER JIM (PRESIDENT) |
| Authorized Official Telephone | 6268003860 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261Q00000X | Clinic/Center | 3985886 | CA | Ambulatory Health Care Facilities |
| Street Address |
452 N ALTADENA DR |
| City | PASADENA |
| State | CA |
| Zip Code | 91107-2536 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801412002 | Kwasi Nkansa | Physical Medicine & Rehabilitation | 2585 East Washington Blvd, Pasadena, CA 91107 | 2020-06-23 |
| 1609402742 | H & S Hospice Care Inc | Hospice Care, Community Based | 2525 E Colordo Blvd Suite 109, Pasadena, CA 91107 | 2020-03-20 |
| 1013557115 | Cindy Phun | Pharmacist | 3383 E Foothill Blvd, Pasadena, CA 91107 | 2020-01-07 |
| 1184185548 | Preferred Home Health Services | Home Health | 40 N Atlandena Dr Suite 219, Pasadena, CA 91107 | 2019-03-28 |
| 1861973729 | Julia E Underwood | Doula | 2335-115 E. Colorado Blvd #339, Pasadena, CA 91107 | 2018-08-28 |
| 1982183166 | Melissa Castillo | Counselor | 26 S Kinneloa Ave, Pasadena, CA 91107 | 2018-08-09 |
| 1083109904 | Lourice Boutros | Optometrist | 3235 E Colorado Blvd Ste 101, Pasadena, CA 91107 | 2018-06-22 |
| 1902313026 | Cecily Brogdon | Marriage & Family Therapist | 2115 Lambert Drive, Pasadena, CA 91107 | 2018-01-10 |
| 1790204915 | Vanessa Nicole Contreras | Licensed Vocational Nurse | 36 S. Kinneiloa Ave., Pasadena, CA 91107 | 2017-09-19 |
| 1730614397 | Rita Mason | Behavioral Analyst | 890 S Rosemead Blvd, Ste 45, Pasadena, CA 91107 | 2017-04-20 |
| Find all providers in zip 91107 | ||||
| Taxonomy Code | 261Q00000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| A facility or distinct part of one used for the diagnosis and treatment of outpatients. "Clinic/Center" is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528691417 | Mindful Healing Heart Reiki & Acupuncture Corp. | Clinic/Center | 2801 E Foothill Blvd, Pasadena, CA 91107-3463 | 2020-02-19 |
| 1083076442 | Kevin Farnam, M.d., Inc. | Clinic/Center | 65 N Madison Ave Ste 202, Pasadena, CA 91101-5248 | 2016-03-24 |
| 1235599598 | White Memorial Medical Center | Clinic/Center | 259 N Euclid Ave, Apt 12, Pasadena, CA 91101-1516 | 2016-02-29 |
| 1154714772 | R&r Clinical | Clinic/Center | 1403 N Fair Oaks Ave Ste 1, Pasadena, CA 91103-1865 | 2015-03-06 |
| 1184963183 | Cac-family Medical Centers | Clinic/Center | 3901 Spencer Hwy, Pasadena, TX 77504-1205 | 2013-02-11 |
| 1295053023 | Cal Tex Medical Management Associates, LLC | Clinic/Center | 908 E Southmore Ave Ste 340, Pasadena, TX 77502-1133 | 2010-05-04 |
| 1912237702 | Fairmont Weight Loss Clinic LLC | Clinic/Center | 4416 Fairmont Pkwy Ste 108, Pasadena, TX 77504-3327 | 2009-12-30 |
| 1700019882 | Zuhair Albana Md Pa | Clinic/Center | 1946 Pasadena Blvd, Pasadena, TX 77502-2742 | 2009-08-24 |
| 1144434341 | Laser Eye Care of California, LLC | Clinic/Center | 790 E Colorado Blvd, Ste. 100, Pasadena, CA 91101-2113 | 2007-05-09 |
| 1649308412 | Neurolink Diagnostics Co. LLC. | Clinic/Center | 600 S. Lake Ave, #205, Pasadena, CA 91106 | 2007-03-01 |
| 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.