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Organization
LISA GLEASON, MD INC.
Active
Organization
LISA GLEASON, MD INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LISA M GLEASON MD (PHYSICIAN/OWNER)
(805) 225-5188
Entity
Organization
Contact information
Practice address
691 MORRO AVE, MORRO BAY, CA 93442-2233
(805) 225-5188
(844) 971-7070
Mailing address
691 MORRO AVE, MORRO BAY, CA 93442-2233
(805) 225-5188
(844) 971-7070
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
—
NULL
208100000X
Physical Medicine & Rehabilitation Physician
Primary
—
—
261QM2500X
Medical Specialty Clinic/Center
A108043
CA
Other
Enumeration date
04/29/2016
Last updated
09/20/2018
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