Provider Demographics
NPI:1245415280
Name:PITINO, LISA MM (DO)
Entity Type:Individual
Prefix:DR
First Name:LISA
Middle Name:MM
Last Name:PITINO
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Gender:F
Credentials:DO
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Mailing Address - Street 1:23521 PASEO DE VALENCIA
Mailing Address - Street 2:SUITE 204
Mailing Address - City:LAGUNA HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:92653-3101
Mailing Address - Country:US
Mailing Address - Phone:949-458-2026
Mailing Address - Fax:949-273-8053
Practice Address - Street 1:23521 PASEO DE VALENCIA
Practice Address - Street 2:SUITE 204
Practice Address - City:LAGUNA HILLS
Practice Address - State:CA
Practice Address - Zip Code:92691-3101
Practice Address - Country:US
Practice Address - Phone:949-458-2026
Practice Address - Fax:949-273-8053
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-09
Last Update Date:2011-04-06
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Provider Licenses
StateLicense IDTaxonomies
CA20A 105712081P2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain Medicine