Mahoney, Lisa M

Mahoney, Lisa M is an individual health care provider with primary practice located at 26520 Cactus Ave , Moreno Valley CA 92555-3927. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Body Imaging, Allopathic & Osteopathic Physicians / Diagnostic Radiology. Allopathic & Osteopathic Physicians / Diagnostic Radiology is her primary health care specialty. Mahoney, Lisa M can be contacted via phone (951) 486-4072.

Contact Information

Primary practice address
26520 Cactus Ave Moreno Valley CA 92555-3927
Phone: (951) 486-4072
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Body Imaging 2085B0100X 01062028 Indiana
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X 01062028 Indiana

Profile Details

NPI number 1609803329
LBN Legal business name Mahoney, Lisa M
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 27th, 2006
Last updated Sep 20th, 2021 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1609803329 NPPES
Indiana MEDICAID 200827180

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