Individual provider Active NPI

Lis A Zin Stark, M.D.

  • Orthopaedic Hand Surgery Physician
  • Downey, CA
National Provider Identifier
1306816418
Registry record updated Oct 5, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Hand Surgery PhysicianTaxonomy code 207XS0106X
License
A41411 Issued in CA
Practice address
8555 Florence Ave
Downey, CA 90240-4014
Phone
(562) 923-9351
NPI assigned
Jan 23, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 5, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Hand Surgery Physician 207XS0106X A41411 CA Primary

Addresses

Primary practice location

8555 Florence Ave
Downey, CA 90240-4014

Mailing address

PO Box 1007
Murrieta, CA 92564-1007
Phone (951) 719-3330

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
I20041006000544 CA Practitioner - Orthopedic SurgeryPractitioner - Hand Surgery 3779542717 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic SurgeryAlso: Hand Surgery
Education
Other, 1978
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

931 Buena Vista St
Suite 505
Duarte, CA 91010-1727
Phone (626) 357-9931

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A41411CAMDOrthopaedic Hand Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lis a Zin Stark, M.D., Inc Hand Surgery CurrentSince Dec 12, 2009 Accepting new patients

Locations

8555 Florence Ave
Downey, CA 90240
Phone (562) 862-9350

931 Buena Vista St
Ste 505
Duarte, CA 91010
Phone (626) 357-9931

1464 Madera Rd
#N182
Simi Valley, CA 93065
Phone (805) 416-1648

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1137974400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1254700800000",
    "number": "1306816418",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1007",
            "city": "MURRIETA",
            "state": "CA",
            "postal_code": "925641007",
            "telephone_number": "951-719-3330",
            "fax_number": "951-296-6706"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8555 FLORENCE AVE",
            "city": "DOWNEY",
            "state": "CA",
            "postal_code": "902404014",
            "telephone_number": "562-923-9351"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STARK",
        "first_name": "LIS",
        "middle_name": "A ZIN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-23",
        "last_updated": "2009-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207XS0106X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Hand Surgery",
            "state": "CA",
            "license": "A41411",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Downey, CA

Sources for this page

Verify at the official NPI Registry.