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Individual

LISA ROBYN O'CONNOR

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
P.T.

Contact information

Practice address
1235 PEAR AVE, # 101, MOUNTAIN VIEW, CA 94043-1444
(650) 965-8434
(650) 965-8545
Mailing address
PO BOX 8125, FOUNTAIN VALLEY, CA 92728-8125
(650) 965-8434
(650) 965-8545

Taxonomy

Speciality
Code
Description
License number
State
204C00000X
Sports Medicine (Neuromusculoskeletal Medicine) Physician
Primary
PT33223
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
PT33223
STATE LICENSE
CA
Enumeration date
02/27/2007
Last updated
11/14/2007
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