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NPI Code Detail

MEDICARE: LISA TUNDE LAZAR

MEDICARE: LISA TUNDE LAZAR
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1390200000XStudent in an Organized Health Care Education/Training ProgramCA

General Provider Information

NPI Number : 1710829189
Entity Type Code : Individual
Provider Name (Legal Business Name) : LISA TUNDE LAZAR
Provider Business Mailing Address
First Line : 28062 BAXTER RD
Second Line : GRADUATE MEDICAL EDUCATION OFFICE
City : MURRIETA
State : CA
Zip : 92563-1401
Country : US
Telephone Number : 951-290-4190
Fax Number :
Provider Business Practice Location Address
First Line : 28062 BAXTER RD
Second Line :
City : MURRIETA
State : CA
Zip : 92563-1401
Country : US
Telephone Number : 951-290-4190
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/07/2026
Last Update Date : 04/07/2026

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Directions to “ LISA TUNDE LAZAR ” Practice Location

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