NPIMap

Individual provider Active NPI

Lisa L Thomsen, M.D.

  • Family Medicine Physician
  • Glendora, CA
National Provider Identifier
1174586960
Registry record updated Jan 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
G63943 Issued in CA
Practice address
210 S Grand Ave Ste 400
Glendora, CA 91741-4279
Phone
(626) 963-4149
NPI assigned
Apr 11, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 17, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X G63943 CA Primary

Addresses

Primary practice location

210 S Grand Ave Ste 400
Glendora, CA 91741-4279

Mailing address

210 S Grand Ave
Suite 302
Glendora, CA 91741-4205
Phone (626) 963-4149

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120417000148 CA Practitioner - Family Practice 0840451985 Reassigns benefits to 2 organizations
Practice locations: Glendora, CA

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Emanate Health Medical Care FoundationGroup PAC ID 9830544980, 85 clinicians

Practice addresses (Care Compare)

1115 S Sunset Ave
West Covina, CA 91790-3940

412 W Carroll Ave
Suite 108
Glendora, CA 91741-4707
Phone (626) 852-0411

Hospital & facility affiliations

  • Prestigious Home Health, Inc Home health agency, Covina, CA, CCN 059193
  • Emanate Health Foothill Presbyterian Hospital Hospital, Glendora, CA, CCN 050597
  • Emanate Health Inter-Community Hospital Hospital, Covina, CA, CCN 050382
  • Casa Colina Hospital Hospital, Pomona, CA, CCN 050782
  • Pomona Valley Hospital Medical Center Hospital, Pomona, CA, CCN 050231
  • City of Hope Helford Clinical Research Hospital Hospital, Duarte, CA, CCN 050146

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal or shaving of skin growth1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
63943CAMDEndodontist
G63943CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Emanate Health Medical Care Foundation CurrentSince Sep 1, 2023 Accepting new patients
Citrus Valley Physician Partners Specialist CurrentSince Apr 1, 2023 Accepting new patients
Lisa Thomsen MD Inc a Professional Corporation CurrentSince May 10, 1999 Accepting new patients
Emanate Health Medical Group Family Medicine Current Accepting new patients
Emanate Health Medical Group CurrentSince Apr 1, 2023 Accepting new patients

Locations

210 W San Bernardino Rd
Covina, CA 91723
Phone (626) 858-8580

210 S Grand Ave
Ste 302
Glendora, CA 91741
Phone (626) 963-4149

210 S Grand Ave
Ste 400
Glendora, CA 91741
Phone (626) 335-3527

440 W Foothill Blvd
Glendora, CA 91741
Phone (626) 963-9402

1115 S Sunset Ave
Ste 200
West Covina, CA 91790
Phone (626) 732-8390

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 5

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.

Hospital & facility affiliations 9

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1144713600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737072000000",
    "number": "1174586960",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 S GRAND AVE",
            "address_2": "SUITE 302",
            "city": "GLENDORA",
            "state": "CA",
            "postal_code": "917414205",
            "telephone_number": "626-963-4149",
            "fax_number": "626-936-9023"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 S GRAND AVE STE 400",
            "city": "GLENDORA",
            "state": "CA",
            "postal_code": "917414279",
            "telephone_number": "626-963-4149"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMSEN",
        "first_name": "LISA",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-04-11",
        "last_updated": "2025-01-17",
        "certification_date": "2025-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "G63943",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendora, CA

Sources for this page

Verify at the official NPI Registry.