Individual
LISA K BANH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
9041 MAGNOLIA AVE, SUITE 305, RIVERSIDE, CA 92503-3900
(951) 343-3477
(951) 343-3483
Mailing address
9041 MAGNOLIA AVE, SUITE 305, RIVERSIDE, CA 92503
(951) 343-3477
(951) 343-3483
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
PA16495
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PA16495
PHYSICIAN ASS LICENCE#
CA
Enumeration date
08/10/2005
Last updated
04/04/2024
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