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NPI Code Detail

MEDICARE: LISETTE A. ROBLEDO M.D.

MEDICARE: LISETTE A. ROBLEDO M.D.
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
1208000000XPediatrics Physician036116230IL
2208000000XPediatrics Physician252755NY
3208000000XPediatrics PhysicianA113925CA

General Provider Information

NPI Number : 1063439727
Entity Type Code : Individual
Provider Name (Legal Business Name) : LISETTE A. ROBLEDO M.D.
Provider Business Mailing Address
First Line : 939 S HILL ST APT 435
Second Line :
City : LOS ANGELES
State : CA
Zip : 90015-3098
Country : US
Telephone Number : 773-960-1771
Fax Number :
Provider Business Practice Location Address
First Line : 3945 WHITTIER BLVD
Second Line :
City : LOS ANGELES
State : CA
Zip : 90023-2440
Country : US
Telephone Number : 323-307-0477
Fax Number : 323-307-0492
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/17/2006
Last Update Date : 10/26/2018

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Directions to “ LISETTE A. ROBLEDO M.D.” Practice Location

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