Healthcare Provider Details

I. General information

NPI: 1780839217
Provider Name (Legal Business Name): SEAN PATRICK BREEN D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/25/2008
Last Update Date: 11/25/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8502 E CHAPMAN AVE #636
ORANCE CA
92869-2461
US

IV. Provider business mailing address

8502 E CHAPMAN AVE # 636
ORANGE CA
92869-2461
US

V. Phone/Fax

Practice location:
  • Phone: 760-500-7615
  • Fax:
Mailing address:
  • Phone: 760-500-7615
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QA0505X
TaxonomyAdult Medicine Physician
License Number20A8273
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: