# DR LISA SHIVES, MD, PC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Lisa Shives MD Sleep Solutions
- **Organization subpart:** No

## Provider details

- **NPI number:** 1508215773
- **Authorized official:** LISA JO SHIVES MD (PRESIDENT)
- **Authorized official phone:** (773) 914-4961

## Contact information

- **Practice address:** 1853 LYNDON RD, SAN DIEGO, CA 92103-1644
- **Practice address phone:** (773) 914-4961
- **Mailing address:** 1853 LYNDON RD, SAN DIEGO, CA 92103-1644
- **Mailing address phone:** (773) 914-4961
- **Mailing address fax:** (847) 827-8706

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207RS0012X | Sleep Medicine (Internal Medicine) Physician | — | NULL | Yes |
| 207RS0012X | Sleep Medicine (Internal Medicine) Physician | — | — | Yes |

## Other

- **Enumeration date:** 06/08/2016
- **Last updated:** 10/07/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 1740322825 | NPI | IL |