Individual
LISA DITOMASO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
444 BRUCE ST, YREKA, CA 96097-3450
(530) 841-6292
Mailing address
901 RANCHO LN STE 135, LAS VEGAS, NV 89106-3826
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
20A19666
CA
Other
Enumeration date
04/02/2019
Last updated
01/16/2024
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