Provider Demographics
NPI:1902077092
Name:CONRAD, LINDA D (CFOM)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:D
Last Name:CONRAD
Suffix:
Gender:F
Credentials:CFOM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:43129 SUNNY LANE
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:CA
Mailing Address - Zip Code:93536-4688
Mailing Address - Country:US
Mailing Address - Phone:661-722-9500
Mailing Address - Fax:661-722-9500
Practice Address - Street 1:43129 SUNNY LANE
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:CA
Practice Address - Zip Code:93536-4688
Practice Address - Country:US
Practice Address - Phone:661-722-9500
Practice Address - Fax:661-722-9500
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-17
Last Update Date:2011-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246Z00000XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, Other
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1297400001Medicare NSC