Individual
DR. LISA DIANE HISAW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
710 LAWRENCE EXPY, GME DEPT. 384, SANTA CLARA, CA 95051-5173
(408) 851-4480
Mailing address
710 LAWRENCE EXPY, GME DEPT. 384, SANTA CLARA, CA 95051-5173
(408) 851-4480
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
A141079
CA
390200000X
Student in an Organized Health Care Education/Training Program
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Other
Enumeration date
03/28/2014
Last updated
12/17/2021
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