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General NPI Number Information
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NPI Number | 1497789952
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Entity Type | Individual
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Provider Name | LARRY EUGENE O'CONNOR MD
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Gender | Male
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Dates
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Enumeration Date | 07/10/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 150 MUIR RD
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City | MARTINEZ
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State | CA
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Zip | 94553-4668
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Country | US
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Telephone | 925-372-2751
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Fax | 925-370-4164
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Provider Business Mailing Address
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Address Line | 5 MIDDLE RD
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City | LAFAYETTE
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State | CA
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Zip | 94549-3325
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Country | US
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Telephone | 925-372-2751
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Fax | 925-370-4164
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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 | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | C33388
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License Number State | CA
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