Provider Demographics
NPI:1902919871
Name:CONNER, JULIUS S II (MD)
Entity Type:Individual
Prefix:
First Name:JULIUS
Middle Name:S
Last Name:CONNER
Suffix:II
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16899 W BERNARDO DR
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92127-1603
Mailing Address - Country:US
Mailing Address - Phone:858-499-2704
Mailing Address - Fax:858-521-2111
Practice Address - Street 1:16950 VIA TAZON
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92127-1607
Practice Address - Country:US
Practice Address - Phone:858-499-2600
Practice Address - Fax:858-621-2019
Is Sole Proprietor?:No
Enumeration Date:2006-08-16
Last Update Date:2019-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG62752207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G627520Medicaid
CAE32593Medicare UPIN
CA00G627520Medicaid