Provider Demographics
NPI:1467665356
Name:STEINHOFF, LISA (ABO)
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:
Last Name:STEINHOFF
Suffix:
Gender:F
Credentials:ABO
Other - Prefix:
Other - First Name:SHERYL
Other - Middle Name:
Other - Last Name:THOMPSON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:OPTICIAN
Mailing Address - Street 1:420 THORN ST
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92103-5708
Mailing Address - Country:US
Mailing Address - Phone:619-298-3586
Mailing Address - Fax:619-298-3682
Practice Address - Street 1:420 THORN ST
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92103-5708
Practice Address - Country:US
Practice Address - Phone:619-298-3586
Practice Address - Fax:619-298-3682
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAD6964156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician