Provider Demographics
NPI:1871882266
Name:O'HARA, ERIN SIOBHAN (DO)
Entity type:Individual
Prefix:
First Name:ERIN
Middle Name:SIOBHAN
Last Name:O'HARA
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 E ANAHEIM ST
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:CA
Mailing Address - Zip Code:90744-4516
Mailing Address - Country:US
Mailing Address - Phone:310-522-8700
Mailing Address - Fax:
Practice Address - Street 1:200 E ANAHEIM ST
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:CA
Practice Address - Zip Code:90744-4516
Practice Address - Country:US
Practice Address - Phone:310-522-8700
Practice Address - Fax:949-791-3114
Is Sole Proprietor?:No
Enumeration Date:2011-04-06
Last Update Date:2025-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA11698207Q00000X
CA20A11698207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAGU383ZMedicare PIN