Individual
KEELAN O'CONNELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
MITSCHER WAY BLDG #2258, SAN DIEGO, CA 92145-0004
(858) 307-1011
Mailing address
34800 BOB WILSON DR, SAN DIEGO, CA 92134-1098
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
30394
NE
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
77842
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1518320266
NPI
—
Enumeration date
03/31/2016
Last updated
07/23/2024
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