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Individual

DR. JANE L CONLIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

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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