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Organization
DR LISA SHIVES, MD, PC
Active
Organization
DR LISA SHIVES, MD, PC
Active
Other names
Lisa Shives MD Sleep Solutions
Organization subpart
No
Provider details
NPI number
Authorized official
LISA JO SHIVES MD (PRESIDENT)
(773) 914-4961
Entity
Organization
Contact information
Practice address
1853 LYNDON RD, SAN DIEGO, CA 92103-1644
(773) 914-4961
Mailing address
1853 LYNDON RD, SAN DIEGO, CA 92103-1644
(773) 914-4961
(847) 827-8706
Taxonomy
Speciality
Code
Description
License number
State
207RS0012X
Sleep Medicine (Internal Medicine) Physician
Primary
—
NULL
207RS0012X
Sleep Medicine (Internal Medicine) Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1740322825
NPI
IL
Enumeration date
06/08/2016
Last updated
10/07/2020
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