Lisa A Brockman, DO

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

20A8065 Issued in CA

Practice address

3820 Martin Luther King Jr Blvd
Lynwood, CA 90262-3625

Phone

(310) 632-0415

Fax

(310) 639-2734

NPI assigned

Jun 17, 2005

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy, Doctor of Medicine

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Talbert Medical Group, P.C.

  • Internal Medicine Physician
  • Fountain Valley, CA
  • NPI 1528069176
  NPD (past)

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

{
    "created_epoch": "1118966400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1347840000000",
    "number": "1063417798",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3820 MARTIN LUTHER KING JR BLVD",
            "city": "LYNWOOD",
            "state": "CA",
            "postal_code": "902623625",
            "telephone_number": "310-632-0415",
            "fax_number": "310-639-2734"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3820 MARTIN LUTHER KING JR BLVD",
            "city": "LYNWOOD",
            "state": "CA",
            "postal_code": "902623625",
            "telephone_number": "310-632-0415",
            "fax_number": "310-639-2734"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROCKMAN",
        "first_name": "LISA",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-06-17",
        "last_updated": "2012-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "20A8065",
            "primary": true
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "CA",
            "license": "20A806",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDI CAL #",
            "identifier": "002A80650",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Brandon Byrum LLC
• Kristine Ann Brazas, LVN
• Brian M Lee MD Inc
• Rigoverto Cabrera Briceno, PH.D.
• Jazmine Briones
• Thomas Brodie, M.D
• Herman David Brooks, M.D.
• Branden Brown, RN
• Janee' Brown, NP
• Kenneth Adonis Brown

• Internal Medicine Physician in Lynwood, CA
• Providers in Lynwood, CA by specialty
• Internal Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.