Individual
LISA DOAN BRESHEARS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.P.M.
Contact information
Practice address
299 W FOOTHILL BLVD STE 124, UPLAND, CA 91786-3854
(909) 946-6643
(909) 946-6130
Mailing address
299 W FOOTHILL BLVD STE 124, UPLAND, CA 91786-3854
(909) 946-6643
(909) 946-6130
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
E5372
CA
213EP1101X
Primary Podiatric Medicine Podiatrist
E5372
CA
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
E5372
CA
Other
Enumeration date
07/05/2014
Last updated
07/21/2022
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