Walter Lysinger, CRNA

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

License

RN3187510 Issued in CA

Practice address

591 Gabriel Ave
Yuba City, CA 95993-8625

Phone

(530) 673-2653

Fax

(530) 673-2653

NPI assigned

Jul 26, 2006

Last updated

Feb 7, 2008By the provider in NPPES

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1153872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1202342400000",
    "number": "1023031127",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "591 GABRIEL AVE",
            "city": "YUBA CITY",
            "state": "CA",
            "postal_code": "959938625",
            "telephone_number": "530-673-2653",
            "fax_number": "530-673-2653"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "591 GABRIEL AVE",
            "city": "YUBA CITY",
            "state": "CA",
            "postal_code": "959938625",
            "telephone_number": "530-673-2653",
            "fax_number": "530-673-2653"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LYSINGER",
        "first_name": "WALTER",
        "name_prefix": "Mr.",
        "credential": "CRNA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-26",
        "last_updated": "2008-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "CA",
            "license": "RN3187510",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "RN3187510",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "ZZZ16781Z 13",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Anesthesiology Physician in Yuba City, CA
• Providers in Yuba City, CA by specialty
• Anesthesiology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.