Conrad, Michael D.

Conrad, Michael D. is an individual health care provider with primary practice located at 14150 Culver Dr Ste 100 , Irvine CA 92604-0322. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, which is considered as his primary health care specialty. Conrad, Michael D. can be contacted via phone (949) 552-4584.

Contact Information

Primary practice address
14150 Culver Dr Ste 100 Irvine CA 92604-0322
Phone: (949) 552-4584
Fax: (949) 551-5612
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X NP 15571 California

Profile Details

NPI number 1144335704
LBN Legal business name Conrad, Michael D.
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 21st, 2006
Last updated Dec 5th, 2019 - about 7 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1144335704 NPPES
California Other NP 15571 NP LICENSE
California MEDICAID EFF: 6/11/12-RIALTO NP LICENSE
California MEDICAID EFF:6/11/12 ADELANTO NP LICENSE
California MEDICAID EFF: 6/11/12-S BERN NP LICENSE

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