Individual
LISA LY HATA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
710 LAWRENCE EXPY DEPT 448, SANTA CLARA, CA 95051-5173
(408) 851-4515
Mailing address
2673 RIKKARD DR, THOUSAND OAKS, CA 91362-4609
(805) 558-3894
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
196344
CA
Other
Enumeration date
06/18/2019
Last updated
09/10/2024
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