Healthcare Provider Details

I. General information

NPI: 1881714954
Provider Name (Legal Business Name): DOUGLAS ROBERT CONTE M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/30/2007
Last Update Date: 06/12/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

555 E VALLEY PKWY
ESCONDIDO CA
92025-3048
US

IV. Provider business mailing address

PO BOX 28199
SAN DIEGO CA
92198-0199
US

V. Phone/Fax

Practice location:
  • Phone: 760-739-3240
  • Fax:
Mailing address:
  • Phone: 858-673-2574
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberG69170
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: