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General NPI Number Information
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NPI Number | 1760587992
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Entity Type | Organization
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Legal Business Name | THOMAS A. O'CALLAGHAN
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Dates
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Enumeration Date | 09/13/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 4646 BROCKTON AVE SUITE 301-1A
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City | RIVERSIDE
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State | CA
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Zip | 92506-0102
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Country | US
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Telephone | 951-784-2866
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Fax |
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Provider Business Mailing Address
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Address Line | 1741 STRATFORD CIR
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City | REDLANDS
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State | CA
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Zip | 92374-4229
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Country | US
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Telephone | 909-794-9039
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Fax | 909-794-9286
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Authorized Official
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Title or Position | SURGEON
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Name | DR. THOMAS A O'CALLAGHAN
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Credential | M.D.
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Telephone | 909-794-9039
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 146D00000X
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Taxonomy Name | Personal Emergency Response Attendant
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License Number | 42550
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License Number State | CA
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