Individual
LISA MARIE CANO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.
Contact information
Practice address
1301 20TH ST, SANTA MONICA, CA 90404-2080
(310) 828-7757
Mailing address
418 PIER AVE, SANTA MONICA, CA 90405-5539
(310) 314-9144
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
PA17961
CA
Other
Enumeration date
06/18/2006
Last updated
01/22/2015
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