MEDICARE: BRIAN PATRICK OCONNOR MD

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	207RR0500X	Rheumatology Physician	G040893	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	:	1770641870
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRIAN PATRICK OCONNOR MD

Provider Business Mailing Address
First Line	:	675 S ARROYO PKWY
Second Line	:	STE 400
City	:	PASADENA
State	:	CA
Zip	:	91105-3264
Country	:	US
Telephone Number	:	626-795-4116
Fax Number	:	626-568-3127

Provider Business Practice Location Address
First Line	:	675 S ARROYO PKWY
Second Line	:	STE 400
City	:	PASADENA
State	:	CA
Zip	:	91105-3264
Country	:	US
Telephone Number	:	626-795-4116
Fax Number	:	626-568-3127

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/04/2006
Last Update Date	:	07/15/2011

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