Individual provider Active NPI

Lisette A. Robledo, M.D.

  • Pediatrics Physician
  • Los Angeles, CA
National Provider Identifier
1063439727
Registry record updated Oct 26, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
A113925 Issued in CA
Practice address
3945 Whittier Blvd
Los Angeles, CA 90023-2440
Phone
(323) 307-0477
Fax
(323) 307-0492
NPI assigned
Jul 17, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 26, 2018

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 036116230 IL
Pediatrics Physician 208000000X 252755 NY
Pediatrics Physician 208000000X A113925 CA Primary

Addresses

Primary practice location

3945 Whittier Blvd
Los Angeles, CA 90023-2440

Mailing address

939 S Hill St Apt 435
Los Angeles, CA 90015-3098
Phone (773) 960-1771

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20181109002496 CA Order and Referring Only - Pediatric MedicinePractitioner - Pediatric Medicine 0345347712

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A113925CAMDPediatrics Physician
036116230ILMDPediatrics Physician
252755NYMDPediatrics Physician

NPI Registry JSON

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

{
    "created_epoch": "1153094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1540512000000",
    "number": "1063439727",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "939 S HILL ST APT 435",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900153098",
            "telephone_number": "773-960-1771"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3945 WHITTIER BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900232440",
            "telephone_number": "323-307-0477",
            "fax_number": "323-307-0492"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBLEDO",
        "first_name": "LISETTE",
        "middle_name": "A.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-17",
        "last_updated": "2018-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IL",
            "license": "036116230",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "252755",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A113925",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.