Provider Demographics
NPI:1356549331
Name:WANG, LISA SHING-E LU (MD)
Entity type:Individual
Prefix:
First Name:LISA
Middle Name:SHING-E LU
Last Name:WANG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:LISA
Other - Middle Name:SHING-E
Other - Last Name:LU
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:12462 PUTNAM ST
Mailing Address - Street 2:STE 206
Mailing Address - City:WHITTIER
Mailing Address - State:CA
Mailing Address - Zip Code:90602-1048
Mailing Address - Country:US
Mailing Address - Phone:562-789-5480
Mailing Address - Fax:562-789-5954
Practice Address - Street 1:12462 PUTNAM ST
Practice Address - Street 2:STE 206
Practice Address - City:WHITTIER
Practice Address - State:CA
Practice Address - Zip Code:90602-1048
Practice Address - Country:US
Practice Address - Phone:562-789-5480
Practice Address - Fax:562-789-5954
Is Sole Proprietor?:No
Enumeration Date:2007-07-11
Last Update Date:2013-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA98434207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology