| Doctor Name: | DR. SEAN MICHAEL DRISCOLL |
| NPI Number: | 1487814877 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | MD |
| License Number: | 01067460A |
| Business Practice Address: | 34800 Bob Wilson Dr 34800 Bob Wilson Dr San Diego, CA - 921345000 |
| Business Phone Number: | 6195450230 |
| Business Fax Number: | |
| Mailing Address: | 34800 Bob Wilson Dr, Naval Medical Ctr SAN DIEGO |
| State: | CA |
| Postal Code: | 921345000 |
| Phone Number: | |
| Fax Number: | |
| NPI Enumeration Date: | 06/10/2008 |
| NPI Last Update Date: | 05/05/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | 01067460A |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IN |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |