Provider Demographics
NPI:1013898097
Name:MUELLER, LISA MARIE (PHARMD)
Entity type:Individual
Prefix:
First Name:LISA
Middle Name:MARIE
Last Name:MUELLER
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4422 MARRACO DR
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92115-5643
Mailing Address - Country:US
Mailing Address - Phone:619-307-1034
Mailing Address - Fax:
Practice Address - Street 1:4422 MARRACO DR
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92115-5643
Practice Address - Country:US
Practice Address - Phone:619-307-1034
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-09-08
Last Update Date:2025-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA589721835E0208X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835E0208XPharmacy Service ProvidersPharmacistEmergency Medicine