| Doctor Name: | LISA GEORGE |
| NPI Number: | 1497051429 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | 19868 |
| Business Practice Address: | 705 Palm Ave Imperial Beach, CA - 919321229 |
| Business Phone Number: | 6194245106 |
| Business Fax Number: | 6194243648 |
| Mailing Address: | 10188 Fabled Waters Ct, SPRING VALLEY |
| State: | CA |
| Postal Code: | 919773458 |
| Phone Number: | 6199487762 |
| Fax Number: | |
| NPI Enumeration Date: | 02/09/2011 |
| NPI Last Update Date: | 02/09/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LP2300X |
| License Number: | 19868 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Primary Care |
| Taxonomy Definition: | |