Individual
BREANNE O'LEARY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
200 W ARBOR DR, SAN DIEGO, CA 92103-9000
(800) 926-8273
Mailing address
PO BOX 232410, SAN DIEGO, CA 92193-2410
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
302253
LA
363A00000X
Physician Assistant
Primary
53722
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02405560
—
MS
05
—
2423843
—
LA
Enumeration date
05/07/2016
Last updated
10/18/2023
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