Individual
NOEL L CONCEPCION
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
6466 BAYVIEW DR, OAKLAND, CA 94605-3134
(209) 277-6792
(209) 844-0334
Mailing address
PO BOX 576649, MODESTO, CA 95357-6649
(209) 573-3333
(209) 844-0334
Taxonomy
Speciality
Code
Description
License number
State
2086S0129X
Vascular Surgery Physician
G56704
CA
2086S0129X
Vascular Surgery Physician
M-1488
GU
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
G56704
CA
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
M-1488
GU
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CD069A
MEDICARE GROUP PTAN
CA
05
—
ZZZ76734Z
—
CA
Enumeration date
06/14/2006
Last updated
09/27/2019
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