Individual
DR. ANN REYNOLDS CONNOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
401 E HIGHLAND AVE STE 251, SAN BERNARDINO, CA 92404-3800
(909) 882-4605
(909) 475-2680
Mailing address
3400 DATA DR, ATTN CREDENTIALING/PAYER ENROLLMENT, RANCHO CORDOVA, CA 95670-7956
Taxonomy
Speciality
Code
Description
License number
State
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
01068600A
IN
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
46719
KY
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
G67226
CA
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
MD440110
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G67226
—
CA
01
—
RHC134387
X-RAY SUPERVISOR LIC
CA
Enumeration date
08/31/2006
Last updated
06/17/2022
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