Healthcare Provider Details

I. General information

NPI: 1750494175
Provider Name (Legal Business Name): JAMES OBRIEN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/17/2006
Last Update Date: 02/04/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

606 34TH ST
BAKERSFIELD CA
93301-2208
US

IV. Provider business mailing address

10404 SUNSET CANYON DR
BAKERSFIELD CA
93311-2765
US

V. Phone/Fax

Practice location:
  • Phone: 661-322-8611
  • Fax: 661-322-8008
Mailing address:
  • Phone: 661-664-7693
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberA87526
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: