Provider Demographics
NPI:1306089057
Name:BECHT, LISA CAREY GROSSMAN (MD)
Entity type:Individual
Prefix:
First Name:LISA
Middle Name:CAREY GROSSMAN
Last Name:BECHT
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 1:500 SUPERIOR AVE STE 210
Mailing Address - Street 2:
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92663-3662
Mailing Address - Country:US
Mailing Address - Phone:949-287-5600
Mailing Address - Fax:
Practice Address - Street 1:500 SUPERIOR AVE STE 210
Practice Address - Street 2:
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92663-3662
Practice Address - Country:US
Practice Address - Phone:949-287-5600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-04-10
Last Update Date:2019-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY261722207VE0102X
CAA162962207VE0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VE0102XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyReproductive Endocrinology