Healthcare Provider Details

I. General information

NPI: 1922056670
Provider Name (Legal Business Name): JAMES ERWIN OBRASKY MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: JAMES E OBRASKY MD

II. Dates (important events)

Enumeration Date: 05/05/2006
Last Update Date: 02/09/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2400 E 4TH ST
NATIONAL CITY CA
91950-2026
US

IV. Provider business mailing address

PO BOX 13085
LA JOLLA CA
92039-3085
US

V. Phone/Fax

Practice location:
  • Phone: 858-232-2593
  • Fax:
Mailing address:
  • Phone: 858-232-2593
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License NumberG20587
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: