Individual
LISAN S PENG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
3190 N SWAN RD, TUCSON, AZ 85712-1227
(520) 547-9700
(520) 547-9719
Mailing address
5055 E BROADWAY BLVD STE A100, TUCSON, AZ 85711-3629
(520) 327-0460
(520) 795-0225
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
40621
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
355571
—
AZ
01
—
Z214203
PTAN
AZ
Enumeration date
07/14/2008
Last updated
01/21/2022
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