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Individual
DR. LISA A BROCKMAN
Active
Individual
DR. LISA A BROCKMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
20A8065
CA
208M00000X
Hospitalist Physician
20A806
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
002A80650
MEDI CAL #
CA
Enumeration date
06/17/2005
Last updated
09/17/2012
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