Vincent Lieras, PA
Physician Assistant in Lake Elsinore, CA. Individual provider (NPI-1).
NPI number1477074094
StatusActive
Last updated in NPPESOct 21, 2024
Details
- NPI
- 1477074094
- Entity type
- Individual (NPI-1)
- Name
- Vincent Lieras
- Credential
- PA
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Jul 5, 2017
- Certification date
- Oct 21, 2024
- Last updated
- Oct 21, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363A00000X | Physician Assistant | pa54581 | CA | Yes |
| 207Q00000X | Family Medicine | PA54581 | CA |
Practice location
31581 Canyon Estates DrLake Elsinore, CA 92532-0424
Phone 951-244-3500
Mailing address
30300 Antelope Rd Apt 1826Menifee, CA 92584-9568
Phone 619-203-4536
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All 12 Physician Assistant providers in Lake Elsinore · All 1,060 providers in Lake Elsinore
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