# LISA GLEASON, MD INC.

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1285089029
- **Authorized official:** LISA M GLEASON MD (PHYSICIAN/OWNER)
- **Authorized official phone:** (805) 225-5188

## Contact information

- **Practice address:** 691 MORRO AVE, MORRO BAY, CA 93442-2233
- **Practice address phone:** (805) 225-5188
- **Practice address fax:** (844) 971-7070
- **Mailing address:** 691 MORRO AVE, MORRO BAY, CA 93442-2233
- **Mailing address phone:** (805) 225-5188
- **Mailing address fax:** (844) 971-7070

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208100000X | Physical Medicine & Rehabilitation Physician | — | NULL | Yes |
| 208100000X | Physical Medicine & Rehabilitation Physician | — | — | Yes |
| 261QM2500X | Medical Specialty Clinic/Center | A108043 | CA | — |

## Other

- **Enumeration date:** 04/29/2016
- **Last updated:** 09/20/2018