Provider Demographics
NPI:1609832294
Name:DEL MURO, LIZA MARIE (APRN, BC)
Entity type:Individual
Prefix:MRS
First Name:LIZA
Middle Name:MARIE
Last Name:DEL MURO
Suffix:
Gender:F
Credentials:APRN, BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28287 EVENING STAR DR
Mailing Address - Street 2:
Mailing Address - City:SUN CITY
Mailing Address - State:CA
Mailing Address - Zip Code:92585-8964
Mailing Address - Country:US
Mailing Address - Phone:951-672-0416
Mailing Address - Fax:
Practice Address - Street 1:6659 SYCAMORE CANYON BLVD
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92507-0733
Practice Address - Country:US
Practice Address - Phone:951-697-3275
Practice Address - Fax:951-697-3267
Is Sole Proprietor?:No
Enumeration Date:2006-04-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA4696363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health