Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Q00000X | Family Doctor | 20A5523 | CA |
N | 207QS0010X | Family Doctor - Sports Medicine | 20A5523 | CA |
NPI | 1003990748 |
---|---|
Provider Name | Lisa L. Majer |
First Address | Laguna Hills, CA 92653 |
Second Address | Laguna Hills, CA 92653 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/10/2006 |
Last Update Date | 08/11/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
F01144 | (02) |