Larisa Anatolyevna Lysak

NPI 1700967908 - Family Medicine - 207Q00000X

NPI Details
NPI 1700967908
Gender Female
Enumeration Date 10/17/2006
Last Updated 07/08/2007
Entity Type Individual
Active Over 10 years ago
Practice Location
8100 TIMBERLAKE WAY STE A
SACRAMENTO CA, 95823-5409, US
Phone (916) 681-2539
Fax (916) 681-2469
Business Location
8100 TIMBERLAKE WAY STE A
SACRAMENTO CA, 95823-5409, US
Phone (916) 681-2539
Fax (916) 681-2469
Toxanomy
Taxonomy Code 207Q00000X
License State California
License Number 16740
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According to our database, Mrs. Larisa Anatolyevna Lysak NPI is 1700967908, taxonomy code is 207Q00000X and license number is 16740, license state is located at California. Larisa Anatolyevna Lysak physically located at 8100 Timberlake Way Ste A, Sacramento CA, 95823-5409. NPI Number Larisa Anatolyevna Lysak has the Individual type.

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1700967908 NPI number is provided on an as is basis without warranty of any kind. 1700967908 is maintained by the National Plan & Provider Enumeration System. The contents of Larisa Anatolyevna Lysak are for informational purposes only.