Individual
LISA M ANDERSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PAC
Contact information
Practice address
5700 COOPER FOSTER PARK RD W, LORAIN, OH 44053-4152
(440) 204-7400
(440) 204-7203
Mailing address
PO BOX 3699, NEWPORT BEACH, CA 92659-8699
(949) 574-4638
(949) 574-4680
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA22548
CA
Other
Enumeration date
10/02/2012
Last updated
12/13/2024
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