Healthcare Provider Details

I. General information

NPI: 1881612109
Provider Name (Legal Business Name): LISA LYNN JEWELL MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LISA LYNN HOCHDERFFER MD

II. Dates (important events)

Enumeration Date: 07/17/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3440 LOMITA BLVD SUITE 100
TORRANCE CA
90505-4801
US

IV. Provider business mailing address

3440 LOMITA BLVD SUITE 100
TORRANCE CA
90505-4801
US

V. Phone/Fax

Practice location:
  • Phone: 310-784-0644
  • Fax:
Mailing address:
  • Phone: 310-784-0644
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208200000X
TaxonomyPlastic Surgery Physician
License NumberA78037
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code2082S0099X
TaxonomyPlastic Surgery Within the Head and Neck (Plastic Surgery) Physician
License NumberA78037
License Number StateCA
# 3
Primary TaxonomyY
Taxonomy Code2082S0105X
TaxonomySurgery of the Hand (Plastic Surgery) Physician
License NumberA78037
License Number StateCA
# 4
Primary TaxonomyN
Taxonomy Code2086S0122X
TaxonomyPlastic and Reconstructive Surgery Physician
License NumberA78037
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: