Individual
DR. LYSANDER JIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
452 N ALTADENA DR UNIT 200, PASADENA, CA 91107-2536
(626) 838-5485
Mailing address
601 CAMINO VERDE, SOUTH PASADENA, CA 91030-4139
(626) 297-0400
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
A124122
CA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/20/2011
Last updated
03/21/2017
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