Individual
DR. LISA MIRIAM BENEPE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1911 JOHNSON AVE, SAN LUIS OBISPO, CA 93401-4131
(805) 543-5353
Mailing address
4445 MAGNOLIA AVE, RIVERSIDE, CA 92501-4135
(323) 795-8041
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
A176547
CA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/19/2019
Last updated
06/28/2022
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