Doctor Name: | DR. LISA JUNE MOLIN |
NPI Number: | 1366447138 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | A55137 |
Business Practice Address: | 895 Aerovista Pl 103 San Luis Obispo, CA - 934018724 |
Business Phone Number: | 8055412368 |
Business Fax Number: | |
Mailing Address: | 895 Aerovista Pl, 103 SAN LUIS OBISPO |
State: | CA |
Postal Code: | 934018724 |
Phone Number: | 8055412368 |
Fax Number: | |
NPI Enumeration Date: | 06/16/2005 |
NPI Last Update Date: | 09/29/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | A55137 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |