Shane S O'brien, DEEP SEA DIVING IDC
NPI #1790248375 in Imperial Beach, California
Provider Information
- NPI Number
- 1790248375
- Entity Type
- Individual
- Name
- Shane S O'brien, DEEP SEA DIVING IDC
- Gender
- Not Specified
- Sole Proprietor
- Yes
- Primary Specialty
- Military Health Care Provider
- Credential
- DEEP SEA DIVING IDC
- Enumeration Date
- Apr 10, 2019
- Last Updated
- Apr 10, 2019
Practice Location
- Address
- 842 GEORGIA ST
- City
- Imperial Beach
- State
- California
- ZIP Code
- 91932-2343
- Phone
- (619) 869-1952
Specialties & Taxonomy Codes
| Specialty |
|---|
| Military Health Care Provider |
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