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Contact Information

RONALD D LISKANICH, DO
954 W FOOTHILL BLVD STE B
UPLAND, CA91786
 Phone: 909-949-7500
 Fax: 909-946-1133
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Procedural Dermatology

207NS0135X 07 Physician/Dermatology
Indicates primary specialty

NPI Profile & details for RONALD D LISKANICH · (Male)

NPI # 1245391820
Status Active
Credentials DO (Doctor of Osteopathic)
Entity Individual
Enumeration date 12/13/2006
Last updated 10/18/2018 - About 8 years ago
Sole proprietor 1 Yes
Identifiers
  • CA License # 20A4952
  • CA Medicaid 00AX49520
  • CA Other 020A49520 BLUE SHIELD
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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