Individual
STEPHEN G CONNOLLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4301 N STAR WAY, MODESTO, CA 95356-9262
(209) 577-1200
(209) 577-6517
Mailing address
3116 W MARCH LN STE 200, STOCKTON, CA 95219-2370
(209) 473-6555
(209) 473-6544
Taxonomy
Speciality
Code
Description
License number
State
207ZC0500X
Cytopathology Physician
G588210
CA
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
G58821
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G588210
—
CA
01
—
G58821
STATE LICENSE
CA
Enumeration date
07/10/2006
Last updated
02/24/2025
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