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Individual

LISA TANIMUNE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
500 PARNASSUS AVE, MU WEST, MU-405, BOX 0118, SAN FRANCISCO, CA 94143-2203
(415) 353-1606
(415) 353-1312
Mailing address
500 PARNASSUS AVE, MU WEST, MU-405, BOX 0118, SAN FRANCISCO, CA 94143-2203
(415) 353-1606
(415) 353-1312

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
1127
MA
363AS0400X
Surgical Physician Assistant
Primary
PA18728
CA

Other

Enumeration date
11/22/2006
Last updated
10/28/2008
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