Provider Demographics
NPI:1063788727
Name:O'BRIEN, CONNOR GALEN (MD)
Entity type:Individual
Prefix:DR
First Name:CONNOR
Middle Name:GALEN
Last Name:O'BRIEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:535 MISSION BAY BLVD S
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94143-2156
Mailing Address - Country:US
Mailing Address - Phone:415-353-2873
Mailing Address - Fax:415-353-2528
Practice Address - Street 1:535 MISSION BAY BLVD S
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94143-2156
Practice Address - Country:US
Practice Address - Phone:415-353-2873
Practice Address - Fax:415-353-2528
Is Sole Proprietor?:No
Enumeration Date:2012-03-27
Last Update Date:2021-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA126717207R00000X, 207RC0000X, 207RC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease