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NPI Code Detail

MEDICARE: DR. CARL CONLEY JR. MD

MEDICARE: DR. CARL CONLEY JR. MD
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
1207V00000XObstetrics & Gynecology PhysicianC36794CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1WG36794BOTHERCAPPIN#
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1265480354
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. CARL CONLEY JR. MD
Provider Business Mailing Address
First Line : 4067 VIA ENCINAS
Second Line :
City : CYPRESS
State : CA
Zip : 90630-3431
Country : US
Telephone Number : 714-229-0950
Fax Number : 714-229-8164
Provider Business Practice Location Address
First Line : 10300 COMPTON AVE
Second Line :
City : LOS ANGELES
State : CA
Zip : 90002-3628
Country : US
Telephone Number : 323-568-3023
Fax Number : 323-563-3386
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/04/2006
Last Update Date : 07/09/2007

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