Individual
LIZBETH SISON VICENCIO-REGNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
5145 CLAIR ST, MONTCLAIR, CA 91763
(909) 591-2687
Mailing address
1560 EAST CHEVY CHASE DR, STE 220, GLENDALE, CA 91206-4197
(909) 591-2687
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
A39799
CA
Other
Enumeration date
04/27/2007
Last updated
07/08/2007
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