Individual
LI LISA GE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
6121 N THESTA ST STE 204, FRESNO, CA 93710-5294
(559) 438-7390
Mailing address
PO BOX 28949, FRESNO, CA 93729-8949
(559) 228-5492
Taxonomy
Speciality
Code
Description
License number
State
207RX0202X
Medical Oncology Physician
Primary
47917
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
458940800
—
MN
Enumeration date
12/02/2005
Last updated
05/07/2021
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