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Contact Information

LISA BRAZIL, C.F.N.P.
35 CASA ST STE 320
SAN LUIS OBISPO, CA93405
 Phone: 805-250-4844
 Fax: 057-850-3568
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Family Medicine

207Q00000X 08 Physician/Family Practice
Indicates primary specialty

NPI Profile & details for LISA BRAZIL · (Female)

NPI Number 1154419117
Status Active
Credentials C.F.N.P.
Entity Individual
Enumeration date 10/11/2006
Last updated 01/29/2019 - About 8 months ago
Sole proprietor 1 Yes
Identifiers
  • NM License # R34090
  • NM Medicaid 53704533
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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