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General NPI Number Information
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NPI Number | 1396835302
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Entity Type | Individual
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Provider Name | DR. STEPHEN REED O'CONNELL
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Gender | Male
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Dates
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Enumeration Date | 10/13/2006
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Last Update Date | 05/13/2025
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Provider Practice Location Address
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Address Line | 200 MERCY CIRCLE BLDG H200
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City | CAMP PENDLETON
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State | CA
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Zip | 92055
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Country | US
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Telephone | 760-725-6642
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Fax | 760-725-0083
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Provider Business Mailing Address
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Address Line | 40 BLUE ANCHOR CAY RD
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City | CORONADO
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State | CA
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Zip | 92118-3201
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Country | US
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Telephone | 850-516-3949
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | C160208
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License Number State | CA
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