Provider Demographics
NPI:1336145697
Name:MUSIAL, LISA MARIE (DO)
Entity Type:Individual
Prefix:DR
First Name:LISA
Middle Name:MARIE
Last Name:MUSIAL
Suffix:
Gender:F
Credentials:DO
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Mailing Address - Street 1:6280 JACKSON DR
Mailing Address - Street 2:STE 8
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92119-3436
Mailing Address - Country:US
Mailing Address - Phone:619-464-1608
Mailing Address - Fax:619-461-8738
Practice Address - Street 1:6280 JACKSON DR
Practice Address - Street 2:STE 8
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92119-3436
Practice Address - Country:US
Practice Address - Phone:619-464-1608
Practice Address - Fax:619-461-8738
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-06-22
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CA20A7027204C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes204C00000XAllopathic & Osteopathic PhysiciansNeuromusculoskeletal Medicine, Sports Medicine