Provider Demographics
NPI:1083755060
Name:GARBUTT, LISA D (MD)
Entity Type:Individual
Prefix:DR
First Name:LISA
Middle Name:D
Last Name:GARBUTT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:400 NEWPORT CENTER DR STE 404
Mailing Address - Street 2:
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92660-7687
Mailing Address - Country:US
Mailing Address - Phone:949-640-2023
Mailing Address - Fax:949-640-7182
Practice Address - Street 1:400 NEWPORT CENTER DR STE 404
Practice Address - Street 2:
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92660
Practice Address - Country:US
Practice Address - Phone:949-640-2023
Practice Address - Fax:949-640-7182
Is Sole Proprietor?:No
Enumeration Date:2007-02-10
Last Update Date:2018-09-04
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA90909207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA90909OtherMEDICAL BOARD