Provider Demographics
NPI:1003990748
Name:MAJER, LISA L (DO)
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:L
Last Name:MAJER
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:24411 HEALTH CENTER DR
Mailing Address - Street 2:#510
Mailing Address - City:LAGUNA HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:92653
Mailing Address - Country:US
Mailing Address - Phone:949-452-7525
Mailing Address - Fax:949-452-7511
Practice Address - Street 1:24411 HEALTH CENTER DR
Practice Address - Street 2:#510
Practice Address - City:LAGUNA HILLS
Practice Address - State:CA
Practice Address - Zip Code:92653
Practice Address - Country:US
Practice Address - Phone:949-452-7525
Practice Address - Fax:949-452-7511
Is Sole Proprietor?:No
Enumeration Date:2006-10-25
Last Update Date:2021-11-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA20A5523207QS0010X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207QS0010XAllopathic & Osteopathic PhysiciansFamily MedicineSports Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
F01144Medicare UPIN