Provider Demographics
NPI:1972985083
Name:O'CONNOR HOSPITAL
Entity type:Organization
Organization Name:O'CONNOR HOSPITAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER, FAMILY MEDICINE RESIDENCY
Authorized Official - Prefix:
Authorized Official - First Name:JENA
Authorized Official - Middle Name:
Authorized Official - Last Name:EIDSCHUN
Authorized Official - Suffix:
Authorized Official - Credentials:BS, MA
Authorized Official - Phone:408-283-7676
Mailing Address - Street 1:455 OCONNOR DR
Mailing Address - Street 2:SUITE 200
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95128-1633
Mailing Address - Country:US
Mailing Address - Phone:408-283-7676
Mailing Address - Fax:
Practice Address - Street 1:455 OCONNOR DR
Practice Address - Street 2:SUITE 200
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95128-1633
Practice Address - Country:US
Practice Address - Phone:408-283-7676
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-25
Last Update Date:2015-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital