Individual
JOHN A. CONNOLLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1750 EL CAMINO REAL, SUITE #307, BURLINGAME, CA 94010
(650) 259-1480
(650) 697-7361
Mailing address
325 DISTEL CIR, LOS ALTOS, CA 94022-1408
(650) 652-7015
(650) 697-7361
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
A56059
CA
208800000X
Urology Physician
Primary
A56059
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
ZZZ83789Z
—
CA
Enumeration date
06/22/2005
Last updated
06/23/2020
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