Individual ProviderLisa Renee Di EnnoPediatricsAllopathic & Osteopathic PhysiciansPractice Address3020 Childrens Way, San Diego, CA 92123-4223(858) 966-8800(858) 309-6300PECOS EnrollmentBased on the most recent information from CMS, provider Lisa Renee Di Enno does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records yesterday at 2:29 PM.Profile DetailsProvider ID1407050297Provider TypeIndividualFull NameDi Enno, Lisa ReneeTitleDr.CredentialM.D.GenderFemaleSole ProprietorNoEnumeration Date6/13/2007Last Updated12/9/2021Contact InformationPractice LocationPractice Address3020 Childrens Way, San Diego, CA 92123-4223Phone(858) 966-8800FaxUnlisted FaxMailing LocationMailing Address3020 Childrens Way # Mc5003, San Diego, CA 92123-4223Phone(858) 309-6300FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode208000000XPrimaryDescriptionPediatricsAllopathic & Osteopathic PhysiciansLicenseC162286CaliforniaCode208000000XDescriptionPediatricsAllopathic & Osteopathic PhysiciansLicense0101245344Virginia