Ralph Lissaur, M.D., P.C.

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

License

A88975 Issued in CA

Legal business name

RALPH LISSAUR, M.D., P.C.

Practice address

2085 Rustin Ave
Riverside, CA 92507-2498

Phone

(951) 509-2400

NPI assigned

Mar 30, 2017

Last updated

Mar 30, 2017By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Ralph Lissaur, M.D.NPI 1245287960

Title

President

Phone

(949) 280-9647

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Ralph Lissaur, M.D.

  • Psychiatry Physician
  • Irvine, CA
  • NPI 1245287960
  NPD (past) Authorized official

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

{
    "created_epoch": "1490832000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1490832000000",
    "number": "1275065088",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14252 CULVER DR",
            "address_2": "A-255",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926040317",
            "telephone_number": "949-280-9647"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2085 RUSTIN AVE",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925072498",
            "telephone_number": "951-509-2400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RALPH LISSAUR, M.D., P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-03-30",
        "last_updated": "2017-03-30",
        "status": "A",
        "authorized_official_last_name": "LISSAUR",
        "authorized_official_first_name": "RALPH",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "949-280-9647",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "CA",
            "license": "A88975",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Community/Behavioral Health Agency in Riverside, CA
• Providers in Riverside, CA by specialty
• Community/Behavioral Health Agency in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2017; 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.