Organization Active NPI

Mark C. O'Brien, D.O., Inc.

  • Internal Medicine Physician
  • Vista, CA
National Provider Identifier
1346060860
Registry record updated Oct 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
MARK C. O'BRIEN, D.O., INC.
Practice address
161 Thunder Dr Ste 210
Vista, CA 92083-6052
Phone
(760) 889-1763
NPI assigned
Oct 10, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 10, 2024

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

Authorized official

Name
Dr. Mark Conway O'Brien, DONPI 1497744247
Title
President
Phone
(760) 889-1763

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

161 Thunder Dr Ste 210
Vista, CA 92083-6052

Mailing address

6786 Vermarine CT
Carlsbad, CA 92009-1705
Phone (760) 889-1763

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250114002066 CA Part B Supplier - Clinic/Group Practice 8820526171 Receives reassigned benefits from 1 practitioner
Practice locations: Vista, CA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1728518400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1728518400000",
    "number": "1346060860",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6786 VERMARINE CT",
            "city": "CARLSBAD",
            "state": "CA",
            "postal_code": "920091705",
            "telephone_number": "760-889-1763"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "161 THUNDER DR STE 210",
            "city": "VISTA",
            "state": "CA",
            "postal_code": "920836052",
            "telephone_number": "760-889-1763"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARK C. O'BRIEN, D.O., INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-10-10",
        "last_updated": "2024-10-10",
        "certification_date": "2024-10-10",
        "status": "A",
        "authorized_official_last_name": "O'BRIEN",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "CONWAY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "760-889-1763",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vista, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 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.