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General NPI Number Information
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NPI Number | 1497744247
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Entity Type | Individual
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Provider Name | MARK C O'BRIEN D.O.
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Gender | Male
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Dates
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Enumeration Date | 10/14/2005
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Last Update Date | 04/01/2025
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Provider Practice Location Address
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Address Line | 161 THUNDER DR STE 210
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City | VISTA
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State | CA
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Zip | 92083-6052
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Country | US
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Telephone | 760-216-6500
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Fax | 760-295-4753
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Provider Business Mailing Address
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Address Line | 161 THUNDER DR STE 210
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City | VISTA
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State | CA
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Zip | 92083-6052
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Country | US
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Telephone | 760-216-6500
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Fax | 760-295-4753
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 20A6017
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License Number State | CA
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