Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Lydia B O'Bannon, PA-C

Individual provider Physician Assistant · NPI 1770911620

Lydia B O'Bannon, PA-C is a Physician Assistant in South Lake Tahoe, California. Practices as a sole proprietor and works from 3 locations. Registered with an NPI since 2013.

In the registry since
2013
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

2170 S Ave
South Lake Tahoe, CA 96150-7026
Phone: (530) 543-5554
Fax: (530) 541-3016
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (2)

  • 935 Mica Dr Ste 13, Carson City, NV 89705-7181 — (775) 783-3065
  • 212 Elks Point Rd Ste 200, Zephyr Cove, NV 89448-8001 — (775) 589-8950

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X

Record details

NPI number1770911620
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorYes
NPI enumeratedOctober 30, 2013
Last updated in NPPESJune 25, 2019

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