MEDICARE: DR. DONALD BRIAN CONKLING DVM

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
1	174M00000X	Veterinarian	5967	CA

General Provider Information

NPI Number	:	1922230887
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DONALD BRIAN CONKLING DVM

Provider Business Mailing Address
First Line	:	805 MASSON AVE
Second Line	:
City	:	SAN BRUNO
State	:	CA
Zip	:	94066-3133
Country	:	US
Telephone Number	:	650-952-6454
Fax Number	:	650-871-8185

Provider Business Practice Location Address
First Line	:	805 MASSON AVE
Second Line	:
City	:	SAN BRUNO
State	:	CA
Zip	:	94066-3133
Country	:	US
Telephone Number	:	650-952-6454
Fax Number	:	650-871-8185

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/11/2009
Last Update Date	:	08/11/2009

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