David H Lyon a Professional Corporation

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

00A431800 Issued in CA

Legal business name

DAVID H LYON A PROFESSIONAL CORPORATION

Practice address

4701 Sisk Rd
Suite 103
Modesto, CA 95356-9320

Phone

(888) 582-0814

Fax

(209) 526-6841

NPI assigned

Oct 31, 2014

Organization subpart

No

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

Authorized official

Name

Julie Smith

Title

Supervisor

Phone

(209) 552-7551

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• David H Lyon MD Other name

Locations

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

{
    "created_epoch": "1414713600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1419292800000",
    "number": "1649675778",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 579120",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953579120",
            "telephone_number": "888-582-0814",
            "fax_number": "209-526-6841"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4701 SISK RD",
            "address_2": "SUITE 103",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953569320",
            "telephone_number": "888-582-0814",
            "fax_number": "209-526-6841"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAVID H LYON A PROFESSIONAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-10-31",
        "last_updated": "2014-12-23",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "JULIE",
        "authorized_official_title_or_position": "SUPERVISOR",
        "authorized_official_telephone_number": "209-552-7551"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "00A431800",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE NUMBER",
            "identifier": "00A431800",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "David H Lyon MD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Internal Medicine Physician in Modesto, CA
• Providers in Modesto, CA by specialty
• Internal Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2014; 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.