Organization
DR LISA SHIVES, MD, PC
Active
Other names
Lisa Shives MD Sleep Solutions
Organization subpart
No
Provider details
NPI number
Authorized official
LISA JO SHIVES MD (PRESIDENT)
(773) 914-4961
Entity
Organization
Contact information
Practice address
1853 LYNDON RD, SAN DIEGO, CA 92103-1644
(773) 914-4961
Mailing address
1853 LYNDON RD, SAN DIEGO, CA 92103-1644
(773) 914-4961
(847) 827-8706
Taxonomy
Speciality
Code
Description
License number
State
207RS0012X
Sleep Medicine (Internal Medicine) Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1740322825
NPI
IL
Enumeration date
06/08/2016
Last updated
10/07/2020
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