Organization Active NPI

Lisa P. Uribe, M.D., Inc.

  • Internal Medicine Physician
  • Pasadena, CA
National Provider Identifier
1164766093
Registry record updated Jan 5, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A97604 Issued in CA
Legal business name
LISA P. URIBE, M.D., INC.
Practice address
800 Fairmount Ave
Suite 210
Pasadena, CA 91105-3150
Phone
(626) 243-2221
NPI assigned
Nov 15, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 5, 2019

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

Authorized official

Name
Lisa Uribe, M.D.NPI 1770762528
Title
President
Phone
(626) 243-2221

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X A97604 CA Primary

Addresses

Primary practice location

800 Fairmount Ave
Suite 210
Pasadena, CA 91105-3150

Mailing address

800 Fairmount Ave
Suite 210
Pasadena, CA 91105-3150

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130205000147 CA Part B Supplier - Clinic/Group Practice 8527212208 Receives reassigned benefits from 1 practitioner
Practice locations: South Pasadena, CA

National Provider Directory

National Provider Directory

Locations

2050 Huntington Dr
South Pasadena, CA 91030
Phone (818) 398-5757

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1352937600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1546646400000",
    "number": "1164766093",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 FAIRMOUNT AVE",
            "address_2": "SUITE 210",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911053150"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 FAIRMOUNT AVE",
            "address_2": "SUITE 210",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911053150",
            "telephone_number": "626-243-2221"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LISA P. URIBE, M.D., INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-11-15",
        "last_updated": "2019-01-05",
        "status": "A",
        "authorized_official_last_name": "URIBE",
        "authorized_official_first_name": "LISA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "626-243-2221",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A97604",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pasadena, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.