Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | G70537 | CA |
N | 2080P0202X | Pediatric Cardiologist | G70537 | CA |
NPI | 1033287453 |
---|---|
Provider Name | Lisa Karen Hornberger |
First Address | San Francisco, CA 94143-0214 |
Second Address | San Francisco, CA 94143-0214 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/12/2006 |
Last Update Date | 09/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00G80680 | (05) | CA |
I01723 | (02) | CA |