Individual
LISA SEO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
7115 GREENBACK LN, FL 2, CITRUS HEIGHTS, CA 95621-6133
(916) 733-3460
(916) 650-0266
Mailing address
3400 DATA DR, RANCHO CORDOVA, CA 95670-7956
Taxonomy
Speciality
Code
Description
License number
State
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
A124453
CA
207RH0002X
Hospice and Palliative Medicine (Internal Medicine) Physician
Primary
A124453
CA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
01/12/2012
Last updated
12/11/2023
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