Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VX0000X | Obstetrician | A54373 | CA |
NPI | 1033272901 |
---|---|
Provider Name | Miss Lisa Renee Crane |
First Address | Irvine, CA 92604-1723 |
Second Address | Irvine, CA 92604-1723 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/12/2006 |
Last Update Date | 28/06/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00A543730 | (05) | CA |
G22631 | (02) | CA |