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1669617015
LISA LIANE DIMODICA
SAN LUIS OBISPO, CA
NPI
1669617015
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363A00000X Physician Assistant
(Licence: CA PA14335)
Enumeration Date
2008-12-12
Last Update Date
2008-12-12
Business Address
-- LISA LIANE DIMODICA PA
47 SANTA ROSA ST
SAN LUIS OBISPO, CA 93405-5816
Phone number: 805-542-9596
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Mailing Address
-- LISA LIANE DIMODICA PA
47 SANTA ROSA ST
SAN LUIS OBISPO, CA 93405-5816
Phone number: 805-542-9596
Copy
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