Healthcare Provider Details

I. General information

NPI: 1770641870
Provider Name (Legal Business Name): BRIAN PATRICK OCONNOR MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: BRIAN P OCONNOR MD

II. Dates (important events)

Enumeration Date: 12/04/2006
Last Update Date: 07/15/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

675 S ARROYO PKWY STE 400
PASADENA CA
91105-3264
US

IV. Provider business mailing address

675 S ARROYO PKWY STE 400
PASADENA CA
91105-3264
US

V. Phone/Fax

Practice location:
  • Phone: 626-795-4116
  • Fax: 626-568-3127
Mailing address:
  • Phone: 626-795-4116
  • Fax: 626-568-3127

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License NumberG040893
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: