Individual
DR. JANE L CONLIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
101 THE CITY DR S, ORANGE, CA 92868-3201
(714) 880-7812
Mailing address
200 S MANCHESTER AVE STE 300, ORANGE, CA 92868-3219
(714) 456-2986
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
A88329
CA
208600000X
Surgery Physician
A88329
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00A883290
BC/BS
CA
05
—
1376553024
—
CA
01
—
CB222951
MEDICARE GROUP PTAN
CA
01
—
CB225187
MEDICARE INDIVIDUAL PTAN
CA
Enumeration date
08/08/2006
Last updated
11/04/2022
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