Individual provider Active NPI

Christian Lising, M.D.

  • Family Medicine Physician
  • Brea, CA
National Provider Identifier
1760478606
Registry record updated Apr 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A67386 Issued in CA
Practice address
955 W Imperial Hwy Ste 110
Brea, CA 92821-3814
Phone
(714) 449-6900
NPI assigned
Sep 26, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 21, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X A67386 CA Primary

Addresses

Primary practice location

955 W Imperial Hwy Ste 110
Brea, CA 92821-3814

Mailing address

955 W Imperial Hwy Ste 110
Brea, CA 92821-3814

Other practice location 1

500 W Central Ave
Suite B
Brea, CA 92821-3027
Phone (714) 671-0766

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address urgentcaresjuhmg@sjhhandhmg.allscriptsdirect.net

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
I20041207001276 CA Practitioner - Family Practice 7719943125 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of California, Irvine, California College of Medicine, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Providence Medical FoundationGroup PAC ID 8921993205, 1,461 clinicians

Practice addresses (Care Compare)

1514 Valley Vista Dr
Diamond Bar, CA 91765-3929
Phone (909) 860-1144

15855 Pomona Rincon Rd
BLDG 4
Chino Hills, CA 91709-3162
Phone (909) 929-2511

19333 Bear Valley Rd
Apple Valley, CA 92308-5149

1950 Sunny Crest Dr
Suite 2900
Fullerton, CA 92835-3641
Phone (714) 992-5350

2501 E Chapman Ave
Orange, CA 92869-3204
Phone (714) 633-7175

26800 Crown Valley Pkwy
Mission Viejo, CA 92691-6384

363 S Main St
Suite 110
Orange, CA 92868-3813
Phone (714) 855-3602

5630 E Santa Ana Canyon Rd
Anaheim, CA 92807-3122
Phone (714) 602-2400

Hospital & facility affiliations

  • Providence St. Jude Medical Center Hospital, Fullerton, CA, CCN 050168

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A67386CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Medical Foundation Family Medicine CurrentSince Aug 7, 2000 Accepting new patients
Providence Medical Foundation Family Medicine Current Accepting new patients
Providence Medical Foundation Current Accepting new patients
St Jude Hospital Inc Past Accepting new patients

Locations

200 W Ctr St Promenade
Ste 300
Anaheim, CA 92805
Phone (714) 449-4841

19333 Bear Valley Rd
Ste 106
Apple Valley, CA 92308
Phone (760) 240-5505

955 W Imperial Hwy
Ste 110
Brea, CA 92821
Phone (714) 449-6900

500 W Central Ave
Ste B
Brea, CA 92821
Phone (714) 529-5022

15855 Pomona Rincon Rd
Chino Hills, CA 91709
Phone (909) 264-8666

1514 Valley Vista Dr
Diamond Bar, CA 91765
Phone (909) 560-1144

2251 N Harbor Blvd
Fullerton, CA 92835
Phone (714) 449-6230

1950 Sunny Crest Dr
Ste 2900
Fullerton, CA 92835

100 E Valencia Mesa Dr
Ste 105
Fullerton, CA 92835
Phone (714) 446-5200

26522 La Alameda
Ste 120
Mission Viejo, CA 92691
Phone (949) 282-1671

26800 Crown Valley Pkwy
Ste 150
Mission Viejo, CA 92691
Phone (949) 276-2111

26800 Crown Valley Pkwy
Ste 300
Mission Viejo, CA 92691

395 W Avenida Vista Hermosa
Ste 395F
San Clemente, CA 92672

4300 Rose Dr
Yorba Linda, CA 92886
Phone (714) 528-4211

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": "1127692800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618963200000",
    "number": "1760478606",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "955 W IMPERIAL HWY STE 110",
            "city": "BREA",
            "state": "CA",
            "postal_code": "928213814"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "955 W IMPERIAL HWY STE 110",
            "city": "BREA",
            "state": "CA",
            "postal_code": "928213814",
            "telephone_number": "714-449-6900"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "500 W Central Ave",
            "address_2": "SUITE B",
            "address_purpose": "LOCATION",
            "city": "Brea",
            "state": "CA",
            "postal_code": "928213027",
            "country_code": "US",
            "telephone_number": "714-671-0766",
            "fax_number": "714-257-6132",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LISING",
        "first_name": "CHRISTIAN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-26",
        "last_updated": "2021-04-21",
        "certification_date": "2021-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A67386",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "urgentcaresjuhmg@sjhhandhmg.allscriptsdirect.net",
            "affiliation": "N",
            "address_1": "955 W Imperial Hwy Ste 110",
            "city": "Brea",
            "state": "CA",
            "country_code": "US",
            "postal_code": "928213814",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Brea, CA

Sources for this page

Verify at the official NPI Registry.