Individual
DR. LISA MARIE RONBACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
100 MISSION BLVD STE 2100, JACKSON, CA 95642-2536
(209) 257-5900
Mailing address
PO BOX 255228, SACRAMENTO, CA 95865-5228
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
01045175A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200108490
—
IN
Enumeration date
08/02/2005
Last updated
01/31/2024
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