Provider Demographics
NPI:1285732560
Name:LINTZ, LISA SHARI (MD)
Entity type:Individual
Prefix:
First Name:LISA
Middle Name:SHARI
Last Name:LINTZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:5363 BALBOA BLVD
Mailing Address - Street 2:SUITE 545
Mailing Address - City:ENCINO
Mailing Address - State:CA
Mailing Address - Zip Code:91316-2805
Mailing Address - Country:US
Mailing Address - Phone:818-906-2929
Mailing Address - Fax:818-906-0567
Practice Address - Street 1:5363 BALBOA BLVD
Practice Address - Street 2:SUITE 545
Practice Address - City:ENCINO
Practice Address - State:CA
Practice Address - Zip Code:91316-2805
Practice Address - Country:US
Practice Address - Phone:818-906-2929
Practice Address - Fax:818-906-0567
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2010-01-27
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAG72467207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G724670Medicaid
CA00G724670Medicaid
CAWG72467AMedicare PIN