MEDICARE: DR. GENE RAYMOND CONLEY M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	G40586	CA
2	208800000X	Urology Physician	G40586	CA

General Provider Information

NPI Number	:	1508862335
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. GENE RAYMOND CONLEY M.D.

Provider Business Mailing Address
First Line	:	2615 E CLINTON AVE
Second Line	:
City	:	FRESNO
State	:	CA
Zip	:	93703-2223
Country	:	US
Telephone Number	:	559-228-5366
Fax Number	:	559-228-5309

Provider Business Practice Location Address
First Line	:	2615 E CLINTON AVE
Second Line	:
City	:	FRESNO
State	:	CA
Zip	:	93703-2223
Country	:	US
Telephone Number	:	559-228-5366
Fax Number	:	559-228-5309

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/27/2005
Last Update Date	:	06/12/2015

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