Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RA0001X | Advanced Heart Failure and Transplant Cardiologist | A60327 | CA |
N | 207RC0000X | Internist - Cardiovascular Disease | A60327 | CA |
NPI | 1982615837 |
---|---|
Provider Name | Lynette Lissin |
First Address | Los Altos, CA 94022-1408 |
Second Address | Palo Alto, CA 94301-2322 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/08/2006 |
Last Update Date | 20/05/2020 |