MEDICARE: MICHAEL J. O'LEARY, M.D., INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207YX0901X	Otology & Neurotology Physician	G56751	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1043377245
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MICHAEL J. O'LEARY, M.D., INC.

Provider Business Mailing Address
First Line	:	3590 CAMINO DEL RIO NORTE, STE 101
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92108-1707
Country	:	US
Telephone Number	:	619-742-6587
Fax Number	:	619-367-0398

Provider Business Practice Location Address
First Line	:	3590 CAMINO DEL RIO N
Second Line	:	STE 101
City	:	SAN DIEGO
State	:	CA
Zip	:	92108-1716
Country	:	US
Telephone Number	:	619-229-4903
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. MICHAEL J. O'LEARY
Credential	:	M.D.
Telephone Number	:	619-742-6587

Provider Enumeration Date	:	01/03/2007
Last Update Date	:	09/06/2024

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