Individual
LYSA SAMUEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
3100 TELEGRAPH AVE, #2109 EAST BAY FAMILY PRACTICE MEDICAL GROUP INC, OAKLAND, CA 94609
(510) 645-9900
(510) 645-9919
Mailing address
3100 TELEGRAPH AVE, #2109 EAST BAY FAMILY PRACTICE MEDICAL GROUP INC, OAKLAND, CA 94609
(510) 645-9900
(510) 645-9919
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA16296
—
Other
Enumeration date
05/09/2007
Last updated
07/08/2007
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