Provider Demographics
NPI:1063685410
Name:STIRLING, LISA ANN (MD)
Entity type:Individual
Prefix:
First Name:LISA
Middle Name:ANN
Last Name:STIRLING
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:DEPT LA 22966
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91185-0001
Mailing Address - Country:US
Mailing Address - Phone:760-634-3376
Mailing Address - Fax:760-634-7955
Practice Address - Street 1:477 N EL CAMINO REAL
Practice Address - Street 2:SUITE C204
Practice Address - City:ENCINITAS
Practice Address - State:CA
Practice Address - Zip Code:92024-1328
Practice Address - Country:US
Practice Address - Phone:760-634-3376
Practice Address - Fax:760-634-7955
Is Sole Proprietor?:No
Enumeration Date:2008-04-07
Last Update Date:2011-08-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA115720207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FD757ZMedicare PIN