Provider Demographics
NPI:1285843839
Name:HOSBEIN, LISA M (MD)
Entity Type:Individual
Prefix:DR
First Name:LISA
Middle Name:M
Last Name:HOSBEIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10024 NEWTOWN ROAD
Mailing Address - Street 2:
Mailing Address - City:NEVADA CITY
Mailing Address - State:CA
Mailing Address - Zip Code:95959
Mailing Address - Country:US
Mailing Address - Phone:530-265-9600
Mailing Address - Fax:530-265-9601
Practice Address - Street 1:10024 NEWTOWN ROAD
Practice Address - Street 2:
Practice Address - City:NEVADA CITY
Practice Address - State:CA
Practice Address - Zip Code:95959
Practice Address - Country:US
Practice Address - Phone:530-265-9600
Practice Address - Fax:530-265-9601
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-21
Last Update Date:2013-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG68163207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAE75104Medicare UPIN