Individual
DR. GARY CONRAD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
625 S FAIR OAKS AVE, SUITE 215, PASADENA, CA 91105-2613
(626) 793-4139
(626) 304-8280
Mailing address
3452 E FOOTHILL BLVD, STE 130, PASADENA, CA 91107-6006
(626) 793-2885
(626) 793-6262
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
C37034
CA
207RH0005X
Hypertension Specialist Physician
A58771
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00C370340
—
CA
01
—
W2223
PTAN MEDICARE
CA
Enumeration date
05/16/2006
Last updated
02/26/2020
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