Individual
MRS. LISA JEAN KINNEY-HAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
2185 CITRACADO PKWY, ESCONDIDO, CA 92029-4159
(442) 281-5000
Mailing address
4303 SEA BRIGHT DR, CARLSBAD, CA 92008-3627
(909) 725-8204
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
A109355
CA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/13/2008
Last updated
06/24/2021
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