Michael Henry Lisiak, MD | |
10333 El Camino Real, Atascadero, CA 93423-7001 | |
(805) 468-2000 | |
(805) 466-6011 |
Full Name | Michael Henry Lisiak |
---|---|
Gender | Male |
Speciality | Psychiatry & Neurology - Psychiatry |
Location | 10333 El Camino Real, Atascadero, California |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1104878842 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
2084F0202X | Psychiatry & Neurology - Forensic Psychiatry | A050175 (California) | Primary |
2084P0800X | Psychiatry & Neurology - Psychiatry | A050175 (California) | Primary |
Entity Name | Department Of State Hospitals |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1124078704 PECOS PAC ID: 9638174238 Enrollment ID: O20081031000305 |
Mailing Address | Practice Location Address |
---|---|
Michael Henry Lisiak, MD 1600 9th Street, Room 205 Mailstop 2-3, Sacramento, CA 95814-6414 Ph: (916) 654-2431 | Michael Henry Lisiak, MD 10333 El Camino Real, Atascadero, CA 93423-7001 Ph: (805) 468-2000 |
Dr. Marc H. Reiner, MD Psychiatry & Neurology Medicare: Accepting Medicare Assignments Practice Location: 10333 El Camino Real, Atascadero, CA 93422 Phone: 805-468-2000 | |
Hadley Charles Osran, MD Psychiatry & Neurology Medicare: Medicare Enrolled Practice Location: 10333 El Camino Real, Atascadero, CA 93423 Phone: 805-468-2000 Fax: 805-466-6011 | |
Clarice P Chan, M.D. Psychiatry & Neurology Medicare: Medicare Enrolled Practice Location: 10333 El Camino Real, Atascadero, CA 93422 Phone: 805-468-2000 | |
Dr. Jonathan R Funk, M.D. Psychiatry & Neurology Medicare: Accepting Medicare Assignments Practice Location: 10333 El Camino Real, Atascadero, CA 93422 Phone: 805-468-2188 | |
Dr. James Rafael Pitts, M.D. Psychiatry & Neurology Medicare: Not Enrolled in Medicare Practice Location: 10333 El Camino Real, Atascadero, CA 93422 Phone: 805-468-2055 | |
Elouisa V Dizon, MD Psychiatry & Neurology Medicare: Not Enrolled in Medicare Practice Location: 10333 El Camino Real, Atascadero, CA 93423 Phone: 805-468-2000 Fax: 805-466-6011 |