Healthcare Provider Details

I. General information

NPI: 1811984008
Provider Name (Legal Business Name): THOMAS BYRNES OHARA DC
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 10/03/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

860 S WINCHESTER BLVD SUITE B
SAN JOSE CA
95128-2962
US

IV. Provider business mailing address

860 S WINCHESTER BLVD SUITE B
SAN JOSE CA
95128-2962
US

V. Phone/Fax

Practice location:
  • Phone: 408-984-6364
  • Fax: 408-984-6430
Mailing address:
  • Phone: 408-984-6364
  • Fax: 408-984-6430

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberDC15339
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: