Organization
KRISTELLE LUSBY MD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KRISTELLE LUSBY MD (OWNER)
(760) 586-3876
Entity
Organization
Contact information
Practice address
3425 S BASCOM AVE STE 100, CAMPBELL, CA 95008-7300
(408) 396-1115
Mailing address
3425 S BASCOM AVE STE 100, CAMPBELL, CA 95008-7300
(760) 586-3876
Taxonomy
Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
—
—
2086S0122X
Plastic and Reconstructive Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1932336278
NPPES
—
Enumeration date
04/25/2023
Last updated
04/25/2023
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