Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
LISA PARK
Active Sole ProprietorLISA PARK is a Colon & Rectal Surgery healthcare provider located in LARKSPUR, California. NPI 1568857142 is currently active in the NPPES registry. Verify at CMS.
Colon & Rectal Surgery · LARKSPUR, CA
Registration Details
- NPI Number
- 1568857142
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- Apr 1, 2015 (11.344539635381 yrs)
- Last Updated
- Dec 3, 2021
- Licenses
-
57.027085 (OH)A168789 (CA)
- Sole Proprietor
- Yes
Practice Information
- Address
-
5 BON AIR RD STE 101LARKSPUR, CA, 949391134Browse CA providers · Browse ZIP 94939
- Phone
- 4159242515
- Primary Specialty
-
Colon & Rectal Surgery
208C00000X
- Additional Specialty
- Colon & Rectal Surgery
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.