Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XS0106X | Orthopaedic Hand Surgeon | A41411 | CA |
NPI | 1306816418 |
---|---|
Provider Name | Dr. Lis A Zin Stark |
First Address | Murrieta, CA 92564-1007 |
Second Address | Downey, CA 90240-4014 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/01/2006 |
Last Update Date | 05/10/2009 |