Elise L. Diner, P.A.-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA51307 Issued in CA

Practice address

2040 E Mariposa Ave
El Segundo, CA 90245-5027

Phone

(310) 400-0645

Fax

(424) 270-6232

NPI assigned

Dec 3, 2013

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

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.

• Precision Surgery Professional Corporation

  • Surgery Physician
  • Alhambra, CA
  • NPI 1790611564
  NPD (past)

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

{
    "created_epoch": "1386028800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1575849600000",
    "number": "1902237894",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5365",
            "city": "BEVERLY HILLS",
            "state": "CA",
            "postal_code": "902095365",
            "telephone_number": "310-400-0645",
            "fax_number": "424-270-6232"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2040 E MARIPOSA AVE",
            "city": "EL SEGUNDO",
            "state": "CA",
            "postal_code": "902455027",
            "telephone_number": "310-400-0645",
            "fax_number": "424-270-6232"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DINER",
        "first_name": "ELISE",
        "middle_name": "L.",
        "name_prefix": "Miss",
        "credential": "P.A.-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-12-03",
        "last_updated": "2019-12-09",
        "certification_date": "2019-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA51307",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael Reznor Dill
• Naijah Dillard
• Jennifer Dillon
• Klaire Antoinett Dimarucut
• Camrynn Dimock
• Katie Dinh
• Lamson Dinh
• Raphael Dinh
• Mikaela Diolazo
• Syahara Dirham

• Physician Assistant in El Segundo, CA
• Providers in El Segundo, CA by specialty
• Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2019; 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.