| Organization Name: | BRIAN O'CARROLL, D.P.M., INC. |
| NPI Number: | 1427351535 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | BRIAN DAVID O'CARROLL (OWNER) |
| Mailing Address: | 911 Oak Park Blvd Ste 106 Pismo Beach |
| State: | CA US |
| Postal Code: | 934493406 |
| Phone Number: | 8054819100 |
| Fax Number: | 8054819199 |
| NPI Enumeration Date: | 12/10/2010 |
| NPI Last Update Date: | 03/15/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 213ES0103X |
| License Number: | E4758 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Podiatric Medicine & Surgery Service Providers |
| Taxonomy Classification: | Podiatrist |
| Taxonomy Specialization: | Foot & Ankle Surgery |
| Taxonomy Definition: | |