Individual
DR. LISA M STELLWAGEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
200 W. ARBOR DRIVE, MC 8201, SAN DIEGO, CA 92103-8201
(619) 543-6365
(619) 543-3183
Mailing address
200 W ARBOR DR, MC 8774, SAN DIEGO, CA 92103-8774
(619) 543-6288
(619) 543-3812
Taxonomy
Speciality
Code
Description
License number
State
2080N0001X
Neonatal-Perinatal Medicine Physician
Primary
G58014
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G580140
—
CA
Enumeration date
06/26/2006
Last updated
07/08/2007
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