O'Carroll, Brian David

O'Carroll, Brian David is an individual health care provider with primary practice located at 911 Oak Park Blvd Ste 106, Pismo Beach CA 93449-3406. He recently has only one registered license in Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery, which is considered as his primary health care specialty. O'Carroll, Brian David can be contacted via phone (805) 481-9100.

Contact Information

Primary practice address
911 Oak Park Blvd Ste 106 Pismo Beach CA 93449-3406
Phone: (805) 481-9100
Fax: (805) 481-9199
Website:
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Health care specialties

SpecialtyCodeLicense #State
Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery 213ES0103X E4758 California

Profile Details

NPI number 1336133768
LBN Legal business name O'Carroll, Brian David
Credentials Doctor of Podiatric Medicine (DPM)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 31st, 2005
Last updated Mar 15th, 2012 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1336133768 NPPES
Illinois MEDICAID 016004922
Illinois Other E4758
Illinois Other 000E47580

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