Healthcare Provider Details

I. General information

NPI: 1447090105
Provider Name (Legal Business Name): MEG OHARE MD INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/30/2024
Last Update Date: 07/02/2024
Certification Date: 07/02/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

675 YGNACIO VALLEY RD STE B214
WALNUT CREEK CA
94596-8209
US

IV. Provider business mailing address

675 YGNACIO VALLEY RD STE B214
WALNUT CREEK CA
94596-8209
US

V. Phone/Fax

Practice location:
  • Phone: 925-937-8346
  • Fax: 925-232-9621
Mailing address:
  • Phone: 925-937-8346
  • Fax: 925-232-9621

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code202K00000X
TaxonomyPhlebology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. MEG MARY O'HARE
Title or Position: MEDICAL DIRECTOR
Credential: MD
Phone: 415-596-4711