| Doctor Name: | LISA PATRICIA URIBE |
| NPI Number: | 1770762528 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MD |
| License Number: | A97604 |
| Business Practice Address: | 800 Fairmount Ave 210 Pasadena, CA - 911053150 |
| Business Phone Number: | 6262432221 |
| Business Fax Number: | |
| Mailing Address: | 800 Fairmount Ave, 210 PASADENA |
| State: | CA |
| Postal Code: | 911053150 |
| Phone Number: | |
| Fax Number: | |
| NPI Enumeration Date: | 10/29/2007 |
| NPI Last Update Date: | 09/17/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | A97604 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |