Provider Demographics
NPI:1558517284
Name:O'CONNOR, BETHANY MARIE STELNICKI (MD)
Entity Type:Individual
Prefix:DR
First Name:BETHANY
Middle Name:MARIE STELNICKI
Last Name:O'CONNOR
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:881 DOVER DR STE 120
Mailing Address - Street 2:
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92663-6941
Mailing Address - Country:US
Mailing Address - Phone:949-381-1169
Mailing Address - Fax:949-520-6662
Practice Address - Street 1:881 DOVER DR STE 120
Practice Address - Street 2:
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92663-6941
Practice Address - Country:US
Practice Address - Phone:949-381-1169
Practice Address - Fax:949-520-6662
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-13
Last Update Date:2023-05-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA1173172081P0301X, 208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
No2081P0301XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationBrain Injury Medicine