Healthcare Provider Details

I. General information

NPI: 1518938869
Provider Name (Legal Business Name): CON YEE LING MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/26/2006
Last Update Date: 11/18/2021
Certification Date: 11/18/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 N MARIO CAPECCHI DR
SALT LAKE CITY UT
84113-1103
US

IV. Provider business mailing address

34800 BOB WILSON DR NMCSD, ATTN: MEDICAL STAFF SUPPORT
SAN DIEGO CA
92134-1098
US

V. Phone/Fax

Practice location:
  • Phone: 801-662-4100
  • Fax:
Mailing address:
  • Phone: 619-532-6460
  • Fax: 619-532-6299

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080N0001X
TaxonomyNeonatal-Perinatal Medicine Physician
License Number360677-1205
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: