Individual provider Active NPI

Liezl Avila, D.O.

  • Emergency Medicine Physician
  • Upland, CA
National Provider Identifier
1487064515
Registry record updated Oct 21, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
20A14280 Issued in CA
Practice address
999 San Bernardino Rd
Upland, CA 91786-4920
Phone
(909) 985-2811
NPI assigned
Apr 28, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 20A14280 CA Primary

Addresses

Primary practice location

999 San Bernardino Rd
Upland, CA 91786-4920

Mailing address

999 San Bernardino Rd
Upland, CA 91786-4920
Phone (909) 985-2811

Other names 1

  • Liezl Barrett Former 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
I20160129000552 CA Practitioner - Emergency Medicine 6103129838 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Scripps HealthGroup PAC ID 9234033853, 1,450 clinicians
Mountain View Emergency Physicians Medical Group IncGroup PAC ID 5092606376, 26 clinicians

Practice addresses (Care Compare)

2205 Vista Way
Oceanside, CA 92054-5661
Phone (858) 554-9100

999 San Bernardino Rd
Upland, CA 91786-4920
Phone (909) 985-2811

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
20A14280CAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cep America - California Emergency Medicine Current Accepting new patients
Mountain View Emergency Physicians Medical Group, Inc. Emergency Medicine CurrentSince Nov 27, 2016 Accepting new patients
Cep America - California Emergency Medicine CurrentSince Feb 8, 2021 Accepting new patients
Palomar Emergency Physicians, Inc Emergency Medicine CurrentSince Aug 7, 2021 Accepting new patients
Cep America-California Emergency Medicine CurrentSince Feb 8, 2021 Accepting new patients
Scripps Health Emergency Medicine Current Accepting new patients
Scripps Health Emergency Medicine CurrentSince Apr 3, 2023 Accepting new patients
Scripps Health CurrentSince Apr 3, 2023 Accepting new patients

Locations

400 N Pepper Ave
Colton, CA 92324
Phone (909) 580-1800

2185 Citracado Pkwy
Escondido, CA 92029
Phone (442) 281-5000

9888 Genesee Ave
La Jolla, CA 92037
Phone (858) 457-4123

File 54433
Los Angeles, CA 90074
Phone (858) 784-5645

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

26520 Cactus Ave
Moreno Valley, CA 92555
Phone (951) 486-5610

2205 Vista Way
Oceanside, CA 92054
Phone (760) 704-5400

2205 Vista Way
Ste 130
Oceanside, CA 92054
Phone (760) 704-5911

1150 N Indian Canyon Dr
Palm Springs, CA 92262
Phone (760) 323-6251

15615 Pomerado Rd
Poway, CA 92064
Phone (858) 613-4000

999 San Bernardino Rd
Upland, CA 91786
Phone (909) 920-4841

Organizations & group practices 8

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": "1398643200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603238400000",
    "number": "1487064515",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "999 SAN BERNARDINO RD",
            "city": "UPLAND",
            "state": "CA",
            "postal_code": "917864920",
            "telephone_number": "909-985-2811"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "999 SAN BERNARDINO RD",
            "city": "UPLAND",
            "state": "CA",
            "postal_code": "917864920",
            "telephone_number": "909-985-2811"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AVILA",
        "first_name": "LIEZL",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-04-28",
        "last_updated": "2020-10-21",
        "certification_date": "2020-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "20A14280",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LIEZL",
            "last_name": "BARRETT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Upland, CA

Sources for this page

Verify at the official NPI Registry.