Stellwagen, Lisa M

Stellwagen, Lisa M is an individual health care provider with primary practice located at 200 W. Arbor Drive Mc 8201, San Diego CA 92103-8201. She recently has only one registered license in Allopathic & Osteopathic Physicians / Neonatal-Perinatal Medicine, which is considered as her primary health care specialty. Stellwagen, Lisa M can be contacted via phone (619) 543-6365.

Contact Information

Primary practice address
200 W. Arbor Drive Mc 8201 San Diego CA 92103-8201
Phone: (619) 543-6365
Fax: (619) 543-3183
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Neonatal-Perinatal Medicine 2080N0001X G58014 California

Profile Details

NPI number 1124055348
LBN Legal business name Stellwagen, Lisa M
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 26th, 2006
Last updated Jul 8th, 2007 - about 19 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1124055348 NPPES
California MEDICAID 00G580140

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