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General NPI Number Information
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NPI Number | 1801826573
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Entity Type | Individual
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Provider Name | DENNIS MICHAEL O'BRIEN D.C.
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Gender | Male
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Dates
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Enumeration Date | 07/05/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 4408 SAN JUAN AVE. SUITE 2
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City | FAIR OAKS
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State | CA
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Zip | 95628
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Country | US
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Telephone | 916-965-1564
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Fax | 916-965-3868
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Provider Business Mailing Address
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Address Line | 4408 SAN JUAN AVE SUITE 2
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City | FAIR OAKS
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State | CA
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Zip | 95628-6747
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Country | US
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Telephone | 916-965-1564
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Fax | 916-965-3868
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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 | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 19235
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License Number State | CA
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