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NPI Code Detail

MEDICARE: MR. JAMES C O'CONNELL NP

MEDICARE: MR. JAMES C O'CONNELL NP
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
1111N00000XChiropractorDC 27503CA
2363LP2300XPrimary Care Nurse Practitioner95020240CA

General Provider Information

NPI Number : 1568541951
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. JAMES C O'CONNELL NP
Provider Business Mailing Address
First Line : 90 BAYVIEW ST
Second Line :
City : SAN FRANCISCO
State : CA
Zip : 94124-2339
Country : US
Telephone Number : 415-637-2562
Fax Number :
Provider Business Practice Location Address
First Line : 225 37TH AVE
Second Line :
City : SAN MATEO
State : CA
Zip : 94403-4324
Country : US
Telephone Number : 650-573-2958
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/04/2006
Last Update Date : 03/23/2022

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