Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080N0001X | Neonatal-Perinatal Doctor | G73920 | CA |
NPI | 1003987926 |
---|---|
Provider Name | Lisanne M. Bzoskie |
First Address | Bellflower, CA 90706-2246 |
Second Address | Bellflower, CA 90706-2246 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/11/2006 |
Last Update Date | 14/12/2021 |