Lisa Lee Mathis, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

MD30333 Issued in DC

Practice address

1 Amgen Center Dr
Pediatric Clinic
Thousand Oaks, CA 91320-1730

Phone

(805) 279-9046

NPI assigned

Nov 24, 2006

Last updated

May 21, 2013By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Amgen Inc

  • Clinic/Center
  • Thousand Oaks, CA
  • NPI 1699021873
  NPD (past)

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

{
    "created_epoch": "1164326400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1369094400000",
    "number": "1528134483",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 PINETREE LN",
            "city": "COLFAX",
            "state": "CA",
            "postal_code": "957139706",
            "telephone_number": "301-922-5108",
            "fax_number": "301-796-9744"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 AMGEN CENTER DR",
            "address_2": "PEDIATRIC CLINIC",
            "city": "THOUSAND OAKS",
            "state": "CA",
            "postal_code": "913201730",
            "telephone_number": "805-279-9046"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATHIS",
        "first_name": "LISA",
        "middle_name": "LEE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-24",
        "last_updated": "2013-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "DC",
            "license": "MD30333",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "MD30333",
            "state": "DC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Vandana K Master, D.D.S.
• Tracy K Matalon, MSN, FNP
• Rami Matar, MD
• Alex Matthew Matavosian, PA-C
• Tania Mateos
• John D Matrisciano, MD
• Andrew Kunio Matsunaga, DDS
• Meredith G Matzkin, M.D.
• Tom Maxim
• Juan Maya

• Pediatrics Physician in Thousand Oaks, CA
• Providers in Thousand Oaks, CA by specialty
• Pediatrics Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2013; 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.