Individual
DR. LISHA MAINZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.C.
Contact information
Practice address
790 LAUREL ST STE 15, SAN CARLOS, CA 94070-3165
(650) 595-0203
Mailing address
790 LAUREL ST STE 15, SAN CARLOS, CA 94070-3165
Taxonomy
Speciality
Code
Description
License number
State
111NS0005X
Sports Physician Chiropractor
Primary
DC24972
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DC24972
LICENSE NUMBER
CA
Enumeration date
03/02/2007
Last updated
07/09/2007
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