| Dr Ronald Demetri Liskanich, DO | |
|
954 W Foothill Blvd Ste B, Upland, CA 91786 | |
| (909) 949-7500 | |
| (909) 946-1133 |
| Full Name | Dr Ronald Demetri Liskanich |
|---|---|
| Gender | Male |
| Speciality | Dermatology |
| Experience | 42 Years |
| Location | 954 W Foothill Blvd Ste B, Upland, California |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1245391820 | NPI | - | NPPES |
| 00AX49520 | Medicaid | CA | |
| 020A49520 | Other | CA | BLUE SHIELD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207NS0135X | Dermatology - Procedural Dermatology | 20A4952 (California) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| San Antonio Regional Hospital | Upland, CA | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| J Robert West Md Inc | 8729990973 | 132 |
| Entity Name | J Robert West Md Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1932154788 PECOS PAC ID: 8729990973 Enrollment ID: O20031105000239 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Ronald Demetri Liskanich, DO 954 W Foothill Blvd Ste B, Upland, CA 91786-3782 Ph: (909) 949-7500 | Dr Ronald Demetri Liskanich, DO 954 W Foothill Blvd Ste B, Upland, CA 91786 Ph: (909) 949-7500 |
Andrea Paola Passalacqua, DO Dermatology Medicare: Not Enrolled in Medicare Practice Location: 886 W Foothill Blvd Ste G, Upland, CA 91786 Phone: 909-949-6500 Fax: 909-946-1133 | |
Tan Khac Nguyen, M.D. Dermatology Medicare: Accepting Medicare Assignments Practice Location: 1310 San Bernardino Rd, Suite 207, Upland, CA 91786 Phone: 909-946-8600 Fax: 909-946-8604 | |
Dr. Sandra Lee Rebish, MD Dermatology Medicare: Accepting Medicare Assignments Practice Location: 859 E Foothill Blvd Ste B, Upland, CA 91786 Phone: 909-981-8929 Fax: 909-946-9740 | |
Dr. Arthur Stanley Zimmermann, M.D. Dermatology Medicare: Not Enrolled in Medicare Practice Location: 930 E Foothill Blvd, Suite 1, Upland, CA 91786 Phone: 909-946-7271 Fax: 909-949-0831 | |
Jeffrey Craig Rebish, MD Dermatology Medicare: Accepting Medicare Assignments Practice Location: 859 E Foothill Blvd Ste B, Upland, CA 91786 Phone: 909-981-8929 Fax: 909-946-9740 | |
Dr. Gloria Jane Stevens, M.D. Dermatology Medicare: Accepting Medicare Assignments Practice Location: 954 W Foothill Blvd Ste B, Upland, CA 91786 Phone: 909-949-7500 Fax: 909-946-1133 |