Walter R Obrien MD Inc a Medical Corporation

Primary specialty

Sports Medicine (Family Medicine) PhysicianTaxonomy code 207QS0010X

License

G63193 Issued in CA

Legal business name

WALTER R OBRIEN MD INC A MEDICAL CORPORATION

Doing business as

WALTER OBRIEN MD INC A MEDICAL CORPORATION

Practice address

11710 Wilshire Blvd
Los Angeles, CA 90025-1503

Phone

(310) 477-7276

Fax

(310) 477-5148

NPI assigned

Feb 12, 2010

Organization subpart

No

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

Authorized official

Name

Mr. Walter Ray O'Brien, M DNPI 1346290814

Title

Owner

Phone

(310) 477-7276

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• WALTER OBRIEN MD INC A MEDICAL CORPORATION Doing business as

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Practitioners 2

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

• Walter R O'Brien, M.D.

  • Sports Medicine (Family Medicine) Physician
  • Los Angeles, CA
  • NPI 1346290814
  Medicare reassignment NPD Authorized official
• Dominic Peter Toscano, RPT

  • Physical Therapist
  • Los Angeles, CA
  • NPI 1801210042
  Medicare reassignment NPD

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

{
    "created_epoch": "1265932800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678147200000",
    "number": "1851623029",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11710 WILSHIRE BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900251503",
            "telephone_number": "310-477-7276",
            "fax_number": "310-477-5148"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11710 WILSHIRE BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900251503",
            "telephone_number": "310-477-7276",
            "fax_number": "310-477-5148"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WALTER R OBRIEN MD INC A MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-02-12",
        "last_updated": "2023-03-07",
        "status": "A",
        "authorized_official_last_name": "O'BRIEN",
        "authorized_official_first_name": "WALTER",
        "authorized_official_middle_name": "RAY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "310-477-7276",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "M D"
    },
    "taxonomies": [
        {
            "code": "207QS0010X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine, Sports Medicine",
            "state": "CA",
            "license": "G63193",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G631931",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "WALTER OBRIEN MD INC A MEDICAL CORPORATION",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Walter Jayasinghe MD Apc
• Walter Jayasinghe MD Apc
• Walter Jayasinghe MD Apc
• Walter Jayasinghe MD Apc
• Walter Jayasinghe MD, Apc
• Walter Silva M D Inc
• Walter W. Murrell, PH.D.
• Lauren Alexa Walter-Rozells, MA, AMFT
• Dianna Walter, BA
• Harold Walters

• Sports Medicine (Family Medicine) Physician in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Sports Medicine (Family Medicine) Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.