Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | A131055 | CA |
N | 111NI0900X | Internist | A131055 | CA |
Y | 207RH0003X | Hematology & Oncology | A131055 | CA |
NPI | 1043509797 |
---|---|
Provider Name | Aaron Lisberg |
First Address | Los Angeles, CA 90045-5631 |
Second Address | Santa Monica, CA 90404-2131 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/04/2011 |
Last Update Date | 21/08/2019 |