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General NPI Number Information
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NPI Number | 1346556024
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Entity Type | Individual
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Provider Name | LISA G GILBREATH RCP
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Gender | Female
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Dates
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Enumeration Date | 08/19/2010
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Last Update Date | 08/19/2010
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Provider Practice Location Address
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Address Line | 994 GOLDEN CREST AVE
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City | NEWBURY PARK
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State | CA
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Zip | 91320-5814
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Country | US
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Telephone | 805-498-4344
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Fax |
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Provider Business Mailing Address
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Address Line | 6480 KATHERINE RD SPACE 76
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City | SIMI VALLEY
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State | CA
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Zip | 93063-6401
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Country | US
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Telephone | 805-231-9986
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Fax |
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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 | 227800000X
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Taxonomy Name | Certified Respiratory Therapist
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License Number | RCP1926
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License Number State | CA
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