Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207K00000X | Allergist & Immunologist | G28068 | CA |
NPI | 1205848454 |
---|---|
Provider Name | Dr. Richard D O'connor |
First Address | San Diego, CA 92101-2327 |
Second Address | San Diego, CA 92101-2327 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/08/2006 |
Last Update Date | 25/06/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00G280680 | (05) | CA |
A43597 | (02) | CA |