Individual provider Active NPI

Knef V Lizaso, M.D.

  • Emergency Medicine Physician
  • San Pedro, CA
National Provider Identifier
1396799532
Registry record updated Sep 11, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
A69779 Issued in CA
Practice address
1300 W 7TH Street
Department of Emergency Medicine
San Pedro, CA 90732-3505
Phone
(310) 514-5350
NPI assigned
May 20, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 11, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207P00000X A69779 CA Primary

Addresses

Primary practice location

1300 W 7TH Street
Department of Emergency Medicine
San Pedro, CA 90732-3505

Mailing address

1300 W 7TH Street
Attn: Medical Staff Office
San Pedro, CA 90732-3505
Phone (310) 514-5350

Other identifiers 1

IdentifierTypeStateIssuer
00A697790MedicaidCA

Other names 1

  • Knef V. Lizaso Professional name

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
I20040901000977 CA Practitioner - Emergency Medicine 9436124419 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
University of California, San Francisco School of Medicine, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southern California Emergency Medical GroupGroup PAC ID 4688097066, 24 clinicians

Practice addresses (Care Compare)

1300 W 7TH St
San Pedro, CA 90732-3505
Phone (310) 514-5350

Hospital & facility affiliations

  • Providence Little Co of Mary Med Ctr San Pedro Hospital, San Pedro, CA, CCN 050078

Merit-based Incentive Payment System (MIPS)

Final score
95.31 of 100Reported as group
Quality
83.88
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
11684NVMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Stephen R Shea, M.D., Inc Emergency Medicine Current Accepting new patients
Stephen R. Shea, M.D., Inc. Emergency Medicine CurrentSince Jul 1, 2001 Accepting new patients
Southern California Emergency Medical Group Emergency Medicine CurrentSince Jul 1, 2020 Accepting new patients
Intercommunity Emergency Medical Group Emergency Medicine CurrentSince Oct 15, 2018 Accepting new patients

Locations

11500 Brookshire Ave
Downey, CA 90241
Phone (562) 904-5000

1050 Linden Ave
Long Beach, CA 90813
Phone (562) 491-9000

1300 W 7th St
San Pedro, CA 90732
Phone (310) 514-5350

12401 Washington Blvd
Whittier, CA 90602
Phone (562) 698-0611

4401 W Memorial Rd
Ste 121
Oklahoma City, OK 73134
Phone (405) 749-4560

Organizations & group practices 4

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 2

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": "1148083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1789084800000",
    "number": "1396799532",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1300 W 7TH STREET",
            "address_2": "ATTN: MEDICAL STAFF OFFICE",
            "city": "SAN PEDRO",
            "state": "CA",
            "postal_code": "907323505",
            "telephone_number": "310-514-5350"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 W 7TH STREET",
            "address_2": "DEPARTMENT OF EMERGENCY MEDICINE",
            "city": "SAN PEDRO",
            "state": "CA",
            "postal_code": "907323505",
            "telephone_number": "310-514-5350"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIZASO",
        "first_name": "KNEF",
        "middle_name": "V",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-20",
        "last_updated": "2026-09-11",
        "certification_date": "2026-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "A69779",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A697790",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KNEF",
            "last_name": "LIZASO",
            "middle_name": "V.",
            "credential": "M.D.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in San Pedro, CA

Sources for this page

Verify at the official NPI Registry.