Michael J. O'Leary, M.D., Inc.

Primary specialty

Otology & Neurotology PhysicianTaxonomy code 207YX0901X

License

G56751 Issued in CA

Legal business name

MICHAEL J. O'LEARY, M.D., INC.

Practice address

3590 Camino del Rio N
Ste 101
San Diego, CA 92108-1716

Phone

(619) 229-4903

NPI assigned

Jan 3, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Michael J. O'Leary, M.D.NPI 1417986613

Title

President

Phone

(619) 742-6587

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Michael Joseph O'Leary, M.D.

  • Otology & Neurotology Physician
  • San Diego, CA
  • NPI 1417986613
  Medicare reassignment NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1167782400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1725580800000",
    "number": "1043377245",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3590 CAMINO DEL RIO NORTE, STE 101",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921081707",
            "telephone_number": "619-742-6587",
            "fax_number": "619-367-0398"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3590 CAMINO DEL RIO N",
            "address_2": "STE 101",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921081716",
            "telephone_number": "619-229-4903"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHAEL J. O'LEARY, M.D., INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-03",
        "last_updated": "2024-09-06",
        "certification_date": "2024-09-06",
        "status": "A",
        "authorized_official_last_name": "O'LEARY",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "J.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "619-742-6587",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207YX0901X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Otolaryngology, Otology & Neurotology",
            "state": "CA",
            "license": "G56751",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G567510",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Otology & Neurotology Physician in San Diego, CA
• Providers in San Diego, CA by specialty
• Otology & Neurotology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.