Provider Demographics
NPI:1447273248
Name:HART, LISA SINCLAIR (MD)
Entity type:Individual
Prefix:
First Name:LISA
Middle Name:SINCLAIR
Last Name:HART
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:LISA
Other - Middle Name:MARIE
Other - Last Name:SINCLAIR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:2498 FLAGSTONE DR
Mailing Address - Street 2:
Mailing Address - City:NAPA
Mailing Address - State:CA
Mailing Address - Zip Code:94558-2571
Mailing Address - Country:US
Mailing Address - Phone:707-224-0425
Mailing Address - Fax:
Practice Address - Street 1:747 52ND ST
Practice Address - Street 2:CHILDREN'S HOSPITAL OAKLAND EMERGENCY DEPARTMENT
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94609-1809
Practice Address - Country:US
Practice Address - Phone:510-428-3259
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG0713522080P0204X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0204XAllopathic & Osteopathic PhysiciansPediatricsPediatric Emergency Medicine