Individual provider Active NPI

Jose Alejandro Lira, M.D.

  • Internal Medicine Physician
  • Chino, CA
National Provider Identifier
1821038985
Registry record updated Sep 28, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A30733 Issued in CA
Practice address
5475 Walnut Ave
Chino, CA 91710-2609
Phone
(909) 591-6446
Fax
(909) 591-1309
NPI assigned
Jun 7, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 28, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X A30733 CA Primary

Addresses

Primary practice location

5475 Walnut Ave
Chino, CA 91710-2609

Mailing address

5475 Walnut Ave
Chino, CA 91710-2609
Phone (909) 591-6446

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
I20100315000049 CA Practitioner - Cardiovascular Disease (Cardiology)Practitioner - General PracticePractitioner - Family Practice 3375547391 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A30733CAMDInternal Medicine Physician

Practice roles (1 of 2)

OrganizationSpecialtyStatusNew patients
Chino Medical Group, Inc Internal Medicine CurrentSince Oct 29, 1986 Accepting new patients

Locations

5475 Walnut Ave
Chino, CA 91710
Phone (909) 591-6446

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 1

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": "1149638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1348790400000",
    "number": "1821038985",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5475 WALNUT AVE",
            "city": "CHINO",
            "state": "CA",
            "postal_code": "917102609",
            "telephone_number": "909-591-6446",
            "fax_number": "909-591-1309"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5475 WALNUT AVE",
            "city": "CHINO",
            "state": "CA",
            "postal_code": "917102609",
            "telephone_number": "909-591-6446",
            "fax_number": "909-591-1309"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIRA",
        "first_name": "JOSE",
        "middle_name": "ALEJANDRO",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-07",
        "last_updated": "2012-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A30733",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chino, CA

Sources for this page

Verify at the official NPI Registry.