MEDICARE: DR. MICHAEL W OBRIEN M.D.

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	2084N0400X	Neurology Physician	G77660	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	:	1952382228
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MICHAEL W OBRIEN M.D.

Provider Business Mailing Address
First Line	:	3400 DATA DR
Second Line	:	PHYSICIAN SUPPORT SERVICES - 2ND FL
City	:	RANCHO CORDOVA
State	:	CA
Zip	:	95670-7956
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2510 AIRPARK DR
Second Line	:	STE 301
City	:	REDDING
State	:	CA
Zip	:	96001-2449
Country	:	US
Telephone Number	:	530-252-3500
Fax Number	:	530-242-3546

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

Provider Enumeration Date	:	11/14/2005
Last Update Date	:	02/10/2015

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