O'Bannon, Lydia B

O'Bannon, Lydia B is an sole proprietor health care provider with primary practice located at 2170 South Ave , South Lake Tahoe CA 96150-7026. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as her primary health care specialty. O'Bannon, Lydia B can be contacted via phone (530) 543-5554.

Contact Information

Primary practice address
2170 South Ave South Lake Tahoe CA 96150-7026
Phone: (530) 543-5554
Fax: (530) 541-3016
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X

Profile Details

NPI number 1770911620
LBN Legal business name O'Bannon, Lydia B
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Oct 30th, 2013
Last updated Jun 25th, 2019 - about 7 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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