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John-David Asido Lyons

Family Medicine

Allopathic & Osteopathic Physicians

2098 S Central Ave, Los Angeles, CA 90011-1235

PECOS Enrollment

This provider is enrolled in PECOS as JOHN-DAVID LYONS.

Based on the most recent information from CMS, provider John-David Asido Lyons is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records 15 days ago.

Profile Details

Provider ID
1992287718
Provider Type
Individual
Full Name
Lyons, John-David Asido
Title
Dr.
Credential
MD

Gender
Male
Sole Proprietor
No
Enumeration Date
8/29/2018
Last Updated
9/20/2021

Contact Information

Practice Location

2098 S Central Ave, Los Angeles, CA 90011-1235

(323) 233-3100

(323) 233-4100

Mailing Location

2801 S San Pedro St, Los Angeles, CA 90011-2023

(323) 233-3100

(323) 233-4100

Provider Taxonomies

Code	Description	License
Code 207Q00000X Primary	Description Family Medicine Allopathic & Osteopathic Physicians	License A167265 California

Provider Identifiers

ID	Description	Issuer
ID A167265	Description Other	Issuer MEDICAL BOARD OF CALIFORNIA California
ID 550001520	Description Medicaid	Issuer Unlisted California

John-David Asido Lyons

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Provider Identifiers

ID

Description

Issuer

ID

Description

Issuer

ID

Description

Issuer

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Clinica Del Socorro Medical Group,Inc.

Noya, David Allen

Akintujoye, Oluwatoyin

Lawrence, Patrick Berwyn

Ghalili, Steven

Khosro Vahid, M.D. A Medical Corporation

Olumoya, Jonathan

Harmon, Ronald

Mull, John Dennis