Provider Demographics
NPI:1538172358
Name:SISTOZA, LILYBETH CALINGASAN (MD)
Entity type:Individual
Prefix:MS
First Name:LILYBETH
Middle Name:CALINGASAN
Last Name:SISTOZA
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Gender:F
Credentials:MD
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Mailing Address - Street 1:162 WESTERN BLVD
Mailing Address - Street 2:APT 901
Mailing Address - City:TAMUNING
Mailing Address - State:GU
Mailing Address - Zip Code:96913-3175
Mailing Address - Country:US
Mailing Address - Phone:909-790-5071
Mailing Address - Fax:909-790-5774
Practice Address - Street 1:17264 FOOTHILL BLVD
Practice Address - Street 2:STE A B
Practice Address - City:FONTANA
Practice Address - State:CA
Practice Address - Zip Code:92335-9051
Practice Address - Country:US
Practice Address - Phone:909-428-3900
Practice Address - Fax:909-428-3903
Is Sole Proprietor?:No
Enumeration Date:2006-08-14
Last Update Date:2017-02-12
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Provider Licenses
StateLicense IDTaxonomies
CAA78188207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A781880Medicaid