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NPI Code Detail

MEDICARE: STEVEN T LIS M.D.

MEDICARE:   STEVEN T LIS  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
12085R0202XDiagnostic Radiology PhysicianG87909CA
22085R0202XDiagnostic Radiology Physician35086948OH

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1P00357635OTHEROHRAILROAD MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2000000500789OTHEROHANTHEM
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1386671147
Entity Type Code : Individual
Provider Name (Legal Business Name) : STEVEN T LIS M.D.
Provider Business Mailing Address
First Line : 30000 SANTIAGO RD
Second Line :
City : TEMECULA
State : CA
Zip : 92592-5115
Country : US
Telephone Number : 951-695-0700
Fax Number :
Provider Business Practice Location Address
First Line : 1770 IOWA AVE
Second Line : SUITE 280
City : RIVERSIDE
State : CA
Zip : 92507-2430
Country : US
Telephone Number : 951-786-0801
Fax Number : 951-786-0460
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/27/2006
Last Update Date : 08/28/2009

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Directions to “ STEVEN T LIS M.D.” Practice Location

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