DR. JULIAN GEORGE LIS (NPI# 1932100062) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1932100062 |
| Entity Type | Individual |
| Full Name | DR. JULIAN GEORGE LIS |
| Credential | M.D. |
| Practice Address |
4077 5th Ave San Diego CA 92103-2105 |
| Practice Telephone | 6192607095 |
| Mailing Telephone | 6192607095 |
| Enumeration Date | 2005-08-10 |
| Last Update Date | 2008-03-03 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207P00000X | Emergency Medicine | G77160 | CA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | 00G771600 | 05 | |
| CA | 00G77160 | 05 |
| Street Address |
4077 5TH AVE |
| City | SAN DIEGO |
| State | CA |
| Zip Code | 92103-2105 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154921195 | Michelle Miller | Social Worker | 4077 5th Ave, San Diego, CA 92103-2105 | 2020-10-29 |
| 1356972798 | Andrew Nasseri Md Inc. | Surgery | 4077 5th Ave, San Diego, CA 92103-2105 | 2020-02-03 |
| 1134769573 | Emi Harris | Nurse Practitioner | 4077 5th Ave, San Diego, CA 92103-2105 | 2020-01-14 |
| 1669012217 | Justin Jerluen Lin | Pharmacist | 4077 5th Ave, Mer 52, San Diego, CA 92103 | 2020-01-12 |
| 1972070662 | Blair Shealy | Internal Medicine | 4077 5th Ave, San Diego, CA 92103-2105 | 2018-10-31 |
| 1487143749 | Jovian W Lam | Internal Medicine | 4077 5th Ave, San Diego, CA 92103 | 2018-05-02 |
| 1316452303 | Meghan Murphy | Social Worker | 4077 5th Ave, San Diego, CA 92103-2105 | 2017-12-12 |
| 1508390394 | Kristina Strong | Nurse Practitioner | 4077 5th Ave, San Diego, CA 92103-2105 | 2017-04-18 |
| 1124578117 | Jennifer Agueda | Nurse Practitioner | 4077 5th Ave, San Diego, CA 92103-2105 | 2016-10-13 |
| 1013309962 | Brody Tucker | Social Worker | 4077 5th Ave, San Diego, CA 92103-2105 | 2015-03-02 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174140057 | Carmel Agdeppa | Acupuncturist | Chiropractique, 813 West Washington St., San Diego, CA 92103 | 2020-06-26 |
| 1568082717 | Salina Ann Bambic | Social Worker | 302 Washington Street Suite 420, San Diego, CA 92103 | 2020-04-17 |
| 1467099432 | Lina Hong | Behavior Technician | 3731 6th Ave. Suite 100, San Diego, Ca 92103, San Diego, CA 92103 | 2019-12-09 |
| 1154964567 | Rodger Stacy Questin, Psychologist P.C. | Psychologist | 440 Upas St Apt 402, San Diego, CA 92103 | 2019-10-18 |
| 1932740388 | Grace Tong-ventura | Pharmacist | 200 W. Arbor Drive, #8765, Suite 1-317, San Diego, CA 92103 | 2019-10-07 |
| 1306490453 | Genevieve Cheung | Pharmacist | 200 W Arbor Dr #8765, Department of Pharmacy, San Diego, CA 92103 | 2019-07-26 |
| 1801356837 | Marika Doviak | Acupuncturist | 2370 Hickory St, San Diego, CA 92103 | 2019-03-25 |
| 1982185070 | Tyler Lewis Roberts | Counselor | 4303 3rd Ave, San Diego, CA 92103 | 2018-08-27 |
| 1689151284 | Tori Breanne Blackwell | Occupational Therapist | 3731-a 6th Avenue, San Diego, CA 92103 | 2018-07-26 |
| 1952892614 | Pacific Bay Recovery Inc | Substance Abuse Rehabilitation Facility | 4095 Jackdaw St, San Diego, CA 92103 | 2018-05-29 |
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| 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 |
|---|---|---|---|---|
| 1962947317 | Mark Olcott, M.d., Inc. | Emergency Medicine | 3609 Lotus Dr, San Diego, CA 92106-1136 | 2016-12-21 |
| 1578941019 | Trisha Morshed | Emergency Medicine | 200 W Arbor Dr Mc867, San Diego, CA 92103 | 2015-05-18 |
| 1770995789 | Lindsey Ball | Emergency Medicine | 4647 Zion Ave Ste 1116, San Diego, CA 92120-2507 | 2014-05-24 |
| 1679910558 | Jeffrey Steven Kurz | Emergency Medicine | 3545 Reynard Way, San Diego, CA 92103-3808 | 2013-05-31 |
| 1265876981 | Alexis Lenz | Emergency Medicine | Ucsd 200 W Arbor Dr, Mc8676, San Diego, CA 92103 | 2013-04-24 |
| 1376881078 | Diane Kopeika Gottschalk | Emergency Medicine | 10221 Wateridge Cir, San Diego, CA 92121-2702 | 2013-01-30 |
| 1598000507 | Julie Watkins-torry | Emergency Medicine | 200 W Arbor Dr # Mc8819, San Diego, CA 92103-1911 | 2012-12-02 |
| 1417212739 | Rodney Sidransky | Emergency Medicine | 7841 Balboa Ave, Suite 202, San Diego, CA 92111-2311 | 2012-07-12 |
| 1598044117 | Charlotte Anne Sadler | Emergency Medicine | 200 W Arbor Dr # 8925, San Diego, CA 92103-1911 | 2011-08-12 |
| 1003103235 | Sarah Wilkinson | Emergency Medicine | 200 W Arbor Dr # 8819, San Diego, CA 92103-1911 | 2011-07-08 |
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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.