NPI Profile for LISA D BRESHEARS in UPLAND, CA.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Surgery, Foot & Ankle |
213ES0103X | 48 | Podiatry | |
Podiatrist |
213E00000X | 48 | Podiatry | |
Primary Podiatric Medicine |
213EP1101X | 48 | Podiatry |
| NPI # | 1205242765 |
|
| Status | Active | |
| Credentials | DPM (Doctor of Podiatric Medicine) | |
| Entity | Individual | |
| Enumeration date | 07/05/2014 | |
| Last updated | 07/21/2022 - About 4 years ago | |
| Sole proprietor 1 | No | |
| Identifiers |
|
|
| Hospital affiliation(s) | Not Available |
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LISA D BRESHEARS
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