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Individual

LISET STOLETNIY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
11234 ANDERSON ST, #1617, LOMA LINDA, CA 92354-2804
(909) 558-8590
Mailing address
FILE 54701, LOS ANGELES, CA 90074-4701
(909) 558-8590

Taxonomy

Speciality
Code
Description
License number
State
207RA0001X
Advanced Heart Failure and Transplant Cardiology Physician
Primary
A51258
CA
207RC0000X
Cardiovascular Disease Physician
A51258
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00A512580
CA
Enumeration date
07/12/2006
Last updated
10/02/2015
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