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Individual
MR. WALTER LYSINGER
Active
Individual
MR. WALTER LYSINGER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CRNA
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
RN3187510
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
RN3187510
—
CA
01
—
ZZZ16781Z 13
BLUE SHIELD
CA
Enumeration date
07/26/2006
Last updated
02/07/2008
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