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Individual
MS. TAMARA MISHELLE LUSINYAN
Active
Individual
MS. TAMARA MISHELLE LUSINYAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHYSICIAN ASSISTANT
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA54657
CA
363AM0700X
Medical Physician Assistant
54657
CA
363AS0400X
Surgical Physician Assistant
54657
CA
Other
Enumeration date
09/28/2017
Last updated
11/27/2023
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