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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

SHANE S O'BRIEN, DEEP SEA DIVING IDC

Active Sole Proprietor

SHANE S O'BRIEN, DEEP SEA DIVING IDC is a Military Health Care Provider healthcare provider located in IMPERIAL BEACH, California. NPI 1790248375 is currently active in the NPPES registry. Verify at CMS.

Military Health Care Provider · IMPERIAL BEACH, CA

Registration Details

NPI Number
1790248375
Provider Type
Individual
Gender
Male
NPI Issued
Apr 10, 2019 (7.3892244542565 yrs)
Last Updated
Apr 10, 2019
Sole Proprietor
Yes

Practice Information

Address
842 GEORGIA ST
IMPERIAL BEACH, CA, 919322343
Browse CA providers · Browse ZIP 91932
Phone
6198691952
Primary Specialty
Military Health Care Provider
171000000X

Other Military Health Care Provider Providers in IMPERIAL BEACH, CA

Name Credential NPI
CHRISTIAN RICHARD FLOHR NAVY DIVE IDC 1780920165
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.