Provider Demographics
NPI:1053470591
Name:MILLER, LISA S (MD)
Entity Type:Individual
Prefix:DR
First Name:LISA
Middle Name:S
Last Name:MILLER
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:8010 FROST ST
Mailing Address - Street 2:SUITE 406
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92123
Mailing Address - Country:US
Mailing Address - Phone:858-467-1899
Mailing Address - Fax:858-467-1363
Practice Address - Street 1:8010 FROST ST
Practice Address - Street 2:SUITE 406
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92123
Practice Address - Country:US
Practice Address - Phone:858-467-1899
Practice Address - Fax:858-467-1363
Is Sole Proprietor?:No
Enumeration Date:2006-12-08
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAG59474207XP3100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XP3100XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryPediatric Orthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA0001594740OtherMEDICAL