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General NPI Number Information
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NPI Number | 1609404102
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Entity Type | Individual
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Provider Name | LISA MARIE BIRD MD
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Gender | Female
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Dates
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Enumeration Date | 03/30/2020
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Last Update Date | 08/04/2025
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Provider Practice Location Address
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Address Line | 6041 CADILLAC AVE
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City | LOS ANGELES
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State | CA
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Zip | 90034-1702
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Country | US
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Telephone | 833-574-2273
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Fax |
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Provider Business Mailing Address
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Address Line | 3745 CARDIFF AVE APT 401
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City | LOS ANGELES
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State | CA
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Zip | 90034-3452
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Country | US
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Telephone | 214-738-8450
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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 | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 35.150871
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License Number State | OH
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Taxonomy #3
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | A202529
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License Number State | CA
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