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NPI Code Detail

MEDICARE: MARLYN CERVANIA CONANAN M.D.

MEDICARE:   MARLYN CERVANIA CONANAN  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
1207Q00000XFamily Medicine Physician00A714960CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
100A714960OTHERCAMEDICAL BOARD

General Provider Information

NPI Number : 1003916701
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARLYN CERVANIA CONANAN M.D.
Provider Business Mailing Address
First Line : 3636 N 1ST ST
Second Line : SUITE 150
City : FRESNO
State : CA
Zip : 93726-6800
Country : US
Telephone Number : 559-222-5900
Fax Number : 559-222-0029
Provider Business Practice Location Address
First Line : 3636 N 1ST ST
Second Line : SUITE 150
City : FRESNO
State : CA
Zip : 93726-6800
Country : US
Telephone Number : 559-222-5900
Fax Number : 559-222-0029
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/22/2006
Last Update Date : 07/08/2007

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Directions to “ MARLYN CERVANIA CONANAN M.D.” Practice Location

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