Michelle Lising
Optometrist in Riverside, CA. Individual provider (NPI-1).
NPI number1114582004
StatusActive
Last updated in NPPESOct 13, 2021
Details
- NPI
- 1114582004
- Entity type
- Individual (NPI-1)
- Name
- Michelle Lising
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- May 6, 2019
- Certification date
- Oct 13, 2021
- Last updated
- Oct 13, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 152W00000X | Optometrist | 34569 | CA | Yes |
| 152W00000X | Optometrist | 1078 | NV | |
| 152W00000X | Optometrist | 4455 | OR |
Practice location
10800 Magnolia AveRiverside, CA 92505-3043
Phone 951-353-2000
Mailing address
10800 Magnolia AveRiverside, CA 92505-3043
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