| Edward J. O'connor, Md, Inc. | |
|
2811 Wilshire Blvd Ste 790 Santa Monica CA 90403-4805 | |
| (310) 829-5968 | |
| (310) 453-3685 |
| Full Name | Edward J. O'connor, Md, Inc. |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 2811 Wilshire Blvd Ste 790, Santa Monica, California |
| Authorized Official Name and Position | Edward Joseph O'connor (NEUROLOGIST) |
| Authorized Official Contact | 3108295968 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Edward J. O'connor, Md, Inc. 2811 Wilshire Blvd Ste 790 Santa Monica CA 90403-4805 Ph: (310) 829-5968 | Edward J. O'connor, Md, Inc. 2811 Wilshire Blvd Ste 790 Santa Monica CA 90403-4805 Ph: (310) 829-5968 |
| NPI Number | 1801079678 |
|---|---|
| Provider Enumeration Date | 12/14/2007 |
| Last Update Date | 04/08/2008 |
| Medicare PECOS PAC ID | 2062421712 |
|---|---|
| Medicare Enrollment ID | O20060407000605 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1801079678 | NPI | - | NPPES |
| DE4737 | Other | CA | RAILROAD MEDICARE |
| A24400 | Other | CA | MEDICARE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | A24400 (California) | Primary |
| Provider Name | Edward J Oconnor |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1568466555 PECOS PAC ID: 6608816988 Enrollment ID: I20050505000735 |
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