Provider Demographics
NPI:1669583167
Name:HIGA, LISA (MD)
Entity type:Individual
Prefix:DR
First Name:LISA
Middle Name:
Last Name:HIGA
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 1:2510 WEBSTER ST
Mailing Address - Street 2:
Mailing Address - City:BERKELEY
Mailing Address - State:CA
Mailing Address - Zip Code:94705-2557
Mailing Address - Country:US
Mailing Address - Phone:510-548-6555
Mailing Address - Fax:510-548-3761
Practice Address - Street 1:2510 WEBSTER ST
Practice Address - Street 2:
Practice Address - City:BERKELEY
Practice Address - State:CA
Practice Address - Zip Code:94705-2557
Practice Address - Country:US
Practice Address - Phone:510-548-6555
Practice Address - Fax:510-548-3761
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2025-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG76897207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAG62881Medicare UPIN
CA00G768971Medicare PIN