Individual
STEVEN T LIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1770 IOWA AVE, SUITE 280, RIVERSIDE, CA 92507-2430
(951) 786-0801
(951) 786-0460
Mailing address
30000 SANTIAGO RD, TEMECULA, CA 92592-5115
(951) 695-0700
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
35086948
OH
2085R0202X
Diagnostic Radiology Physician
Primary
G87909
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000500789
ANTHEM
OH
05
—
2695454
—
OH
01
—
P00357635
RAILROAD MEDICARE
OH
Enumeration date
06/27/2006
Last updated
08/28/2009
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