Provider Demographics
NPI:1750342234
Name:LEPINE, LISA ANN (MD)
Entity type:Individual
Prefix:DR
First Name:LISA
Middle Name:ANN
Last Name:LEPINE
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 1:400 W PUEBLO ST
Mailing Address - Street 2:
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93105-4353
Mailing Address - Country:US
Mailing Address - Phone:805-342-4403
Mailing Address - Fax:
Practice Address - Street 1:2416 CASTILLO ST STE A
Practice Address - Street 2:
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93105-5303
Practice Address - Country:US
Practice Address - Phone:805-324-9400
Practice Address - Fax:805-563-5171
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-01
Last Update Date:2024-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG71806207V00000X
WAMD00033919207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO026017OtherKAISER COMMERCIAL NUMBER
CO48574279Medicaid
CO802492Medicare ID - Type Unspecified
G30504Medicare UPIN
CO392139YK5YMedicare PIN