Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204F00000X | Transplant Surgeon | A173264 | CA |
N | 208200000X | Surgeon | A173264 | CA |
N | 208600000X | Surgeon | A173264 | CA |
NPI | 1548659980 |
---|---|
Provider Name | Mr. Daniel O'brien |
First Address | Los Angeles, CA 90045-5631 |
Second Address | Los Angeles, CA 90095-5611 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/01/2015 |
Last Update Date | 09/08/2021 |