Organization
THOMAS CONKLIN
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STEVEN GARRETT M.D. (BILLING MANAGER)
(310) 348-0500
Entity
Organization
Contact information
Practice address
18417 NORDHOFF ST, SUITE 8, NORTHRIDGE, CA 91325-2200
(310) 348-0500
Mailing address
18417 NORDHOFF ST, SUITE 8, NORTHRIDGE, CA 91325-2200
Taxonomy
Speciality
Code
Description
License number
State
207QA0505X
Adult Medicine Physician
Primary
G44486
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G444850
—
CA
Enumeration date
04/10/2007
Last updated
08/22/2020
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