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General NPI Number Information
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NPI Number | 1003956731
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Entity Type | Individual
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Provider Name | LISA M GALSTIAN O.D.
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Gender | Female
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Dates
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Enumeration Date | 02/08/2007
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Last Update Date | 07/09/2007
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Provider Practice Location Address
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Address Line | 7770 REGENTS RD SUITE 104
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City | SAN DIEGO
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State | CA
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Zip | 92122-1937
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Country | US
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Telephone | 858-546-1940
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Fax | 858-546-0940
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Provider Business Mailing Address
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Address Line | 1697 CALLE ALTA
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City | LA JOLLA
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State | CA
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Zip | 92037-7105
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Country | US
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Telephone | 858-273-3919
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Fax | 858-273-5021
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | T08231
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License Number State | CA
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