Provider Demographics
NPI:1144211236
Name:GUINAN, LISA HO (DMD)
Entity Type:Individual
Prefix:DR
First Name:LISA
Middle Name:HO
Last Name:GUINAN
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4826 LINCOLN BLVD
Mailing Address - Street 2:
Mailing Address - City:MARINA DEL REY
Mailing Address - State:CA
Mailing Address - Zip Code:90292-6917
Mailing Address - Country:US
Mailing Address - Phone:310-827-7767
Mailing Address - Fax:310-302-0431
Practice Address - Street 1:4826 LINCOLN BLVD
Practice Address - Street 2:
Practice Address - City:MARINA DEL REY
Practice Address - State:CA
Practice Address - Zip Code:90292-6917
Practice Address - Country:US
Practice Address - Phone:310-827-7767
Practice Address - Fax:310-302-0431
Is Sole Proprietor?:No
Enumeration Date:2005-10-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA436071223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice