Individual
DR. WALTER R O'BRIEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
11600 WILSHIRE BLVD, SUITE 522, LOS ANGELES, CA 90025-5781
(310) 477-7276
(310) 477-5148
Mailing address
11710 WILSHIRE BLVD, LOS ANGELES, CA 90025-1503
(310) 477-7276
(310) 477-5148
Taxonomy
Speciality
Code
Description
License number
State
207QS0010X
Sports Medicine (Family Medicine) Physician
Primary
G063193
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G631931
—
CA
Enumeration date
05/12/2006
Last updated
03/07/2023
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