# WALTER R OBRIEN MD INC A MEDICAL CORPORATION

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- **Entity:** Organization
- **Status:** Active
- **Other names:** WALTER OBRIEN MD INC A MEDICAL CORPORATION
- **Organization subpart:** No

## Provider details

- **NPI number:** 1851623029
- **Authorized official:** MR. WALTER RAY O'BRIEN M D (OWNER)
- **Authorized official phone:** (310) 477-7276

## Contact information

- **Practice address:** 11710 WILSHIRE BLVD, LOS ANGELES, CA 90025-1503
- **Practice address phone:** (310) 477-7276
- **Practice address fax:** (310) 477-5148
- **Mailing address:** 11710 WILSHIRE BLVD, LOS ANGELES, CA 90025-1503
- **Mailing address phone:** (310) 477-7276
- **Mailing address fax:** (310) 477-5148

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207QS0010X | Sports Medicine (Family Medicine) Physician | G63193 | CA | Yes |

## Other

- **Enumeration date:** 02/12/2010
- **Last updated:** 03/07/2023