| Michelle Liske Md Inc | |
|
4340 Genesee Ave Ste 207 San Diego CA 92117-4940 | |
| (858) 356-5600 | |
| (858) 356-4965 |
| Full Name | Michelle Liske Md Inc |
|---|---|
| Speciality | Internal Medicine |
| Location | 4340 Genesee Ave Ste 207, San Diego, California |
| Authorized Official Name and Position | Michelle Liske (PRESIDENT) |
| Authorized Official Contact | 8583565600 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Michelle Liske Md Inc 4340 Genesee Ave Ste 207 San Diego CA 92117-4940 Ph: (858) 356-5600 | Michelle Liske Md Inc 4340 Genesee Ave Ste 207 San Diego CA 92117-4940 Ph: (858) 356-5600 |
| NPI Number | 1558833244 |
|---|---|
| Provider Enumeration Date | 12/19/2018 |
| Last Update Date | 12/19/2018 |
| Medicare PECOS PAC ID | 2365777224 |
|---|---|
| Medicare Enrollment ID | O20190715001676 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1558833244 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Michelle A Liske |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1326366121 PECOS PAC ID: 9234030040 Enrollment ID: I20040115000608 |
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