Individual provider · Type 1 NPI
Shane S. O'Brien, DEEP SEA DIVING IDC
Military Health Care Provider · Imperial Beach, CA
NPI number
1790248375
Active
Practice location
842 Georgia St
Imperial Beach, CA 91932-2343
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Military Health Care Provider Primary | 171000000X | None listed |
Military Health Care Provider: Active duty military health care providers not otherwise classified who need to be separately identified for operational, clinical, or administrative processes.
Other military health care provider providers in Imperial Beach
About NPI 1790248375
Shane S. O'Brien, DEEP SEA DIVING IDC's National Provider Identifier is 1790248375, issued on Apr 10, 2019. The primary taxonomy on file is Military Health Care Provider (171000000X), and the practice location is in Imperial Beach, CA. The record was last updated on Apr 10, 2019.