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General NPI Number Information
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NPI Number | 1538613997
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Entity Type | Individual
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Provider Name | MR. JOHN PAUL GILBERT CONCEPCION7142647041
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Gender | Male
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Dates
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Enumeration Date | 08/15/2016
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Last Update Date | 08/15/2016
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Provider Practice Location Address
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Address Line | 555 W COMPTON BLVD
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City | COMPTON
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State | CA
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Zip | 90220-3085
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Country | US
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Telephone | 310-637-1010
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Fax |
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Provider Business Mailing Address
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Address Line | 17841 LINDA DR
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City | YORBA LINDA
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State | CA
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Zip | 92886-3345
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Country | US
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Telephone | 714-264-7041
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2355S0801X
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Taxonomy Name | Speech-Language Assistant
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License Number | SPA 2924
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License Number State | CA
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