Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | A126717 | CA |
N | 111NI0900X | Internist | A126717 | CA |
N | 207RC0000X | Internist - Cardiovascular Disease | A126717 | CA |
Y | 207RC0200X | Critical Care Medicine | A126717 | CA |
NPI | 1063788727 |
---|---|
Provider Name | Dr. Connor Galen O'brien |
First Address | San Francisco, CA 94143-2156 |
Second Address | San Francisco, CA 94143-2156 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/03/2012 |
Last Update Date | 16/09/2021 |