Healthcare Provider Details

I. General information

NPI: 1366071805
Provider Name (Legal Business Name): LISA S O'KANE D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/06/2020
Last Update Date: 08/11/2025
Certification Date: 08/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8900 BEVERLY BLVD FL 3
WEST HOLLYWOOD CA
90048-2438
US

IV. Provider business mailing address

4140 W 190TH ST
TORRANCE CA
90504-5513
US

V. Phone/Fax

Practice location:
  • Phone: 310-423-2641
  • Fax: 310-423-4552
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number20A23822
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: