Organization
LISA'S CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BILL CHANG (MANAGER)
(408) 530-9361
Entity
Organization
Contact information
Practice address
877 W FREMONT AVE, M2, SUNNYVALE, CA 94087-2315
(408) 530-9361
Mailing address
877 W. FREMONT AVE, M2, SUNNYVALE, CA 94087
(408) 530-9361
Taxonomy
Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
Primary
—
—
Other
Enumeration date
10/12/2012
Last updated
10/12/2012
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