MEDICARE: BRIAN OLIVER WARNECKE D.O.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	20A20086	CA
2	207RH0003X	Hematology & Oncology Physician	20A20086	CA

General Provider Information

NPI Number	:	1356804421
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRIAN OLIVER WARNECKE D.O.

Provider Business Mailing Address
First Line	:	101 THE CITY DRIVE SOUTH
Second Line	:	BUILDING 56, ZOT 4061
City	:	ORANGE
State	:	CA
Zip	:	92868
Country	:	US
Telephone Number	:	714-456-5153
Fax Number	:

Provider Business Practice Location Address
First Line	:	200 S MANCHESTER AVE STE 400
Second Line	:
City	:	ORANGE
State	:	CA
Zip	:	92868-3220
Country	:	US
Telephone Number	:	714-456-7772
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/07/2019
Last Update Date	:	09/04/2025

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