Individual
DR. MICHAEL ANDRE LISS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
200 W ARBOR DR, SAN DIEGO, CA 92103-9000
(800) 926-8273
(888) 539-8781
Mailing address
FILE 57326, LOS ANGELES, CA 90074-7326
(858) 249-6748
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
A101260
CA
208800000X
Urology Physician
Q0497
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
339266401
—
TX
Enumeration date
11/12/2007
Last updated
07/11/2024
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