Individual
COURTNEY E O'ROURKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
9909 MIRA MESA BLVD STE 110, SAN DIEGO, CA 92131-1060
(858) 554-1212
(858) 795-1195
Mailing address
9850 GENESEE AVE STE 320, LA JOLLA, CA 92037-1208
(858) 554-1212
(858) 795-1195
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
20A11824
CA
207R00000X
Internal Medicine Physician
48004-021
WI
208M00000X
Hospitalist Physician
20A11824
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
43524300
—
WI
01
—
FQ785Z
MEDICARE PART B CA
CA
01
—
P00261156
RR MEDICARE
—
Enumeration date
07/01/2006
Last updated
02/22/2024
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