Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days.
Individual
DR. DOUGLAS GAVIN KONDO
Active
Individual
DR. DOUGLAS GAVIN KONDO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
6313601-1205
UT
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
6313601-1205
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11725447
CAQH NUMBER
UT
01
—
6313601-1205
UTAH MEDICAL LICENSE
UT
Enumeration date
10/12/2006
Last updated
03/07/2023
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign upProduct
Developers