Individual
LISA M. MORENO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
2823 FRESNO ST, FRESNO, CA 93721-1324
(559) 459-6000
(559) 459-3750
Mailing address
2625 E DIVISADERO ST, FRESNO, CA 93721-1431
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
PA18308
CA
Other
Enumeration date
03/08/2006
Last updated
04/18/2016
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