Provider Demographics
NPI:1609932045
Name:ZACHAREWICZ, LISA JOAN (MD)
Entity Type:Individual
Prefix:DR
First Name:LISA
Middle Name:JOAN
Last Name:ZACHAREWICZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:24 WILLIE MAYS PLZ
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94107-2134
Mailing Address - Country:US
Mailing Address - Phone:415-972-2249
Mailing Address - Fax:415-947-3099
Practice Address - Street 1:24 WILLIE MAYS PLZ
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94107-2134
Practice Address - Country:US
Practice Address - Phone:415-972-2249
Practice Address - Fax:415-947-3099
Is Sole Proprietor?:No
Enumeration Date:2006-12-29
Last Update Date:2012-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG079464207R00000X
MOMDR6H24207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine