GEORGE I CONKLIN (NPI# 1205819836) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1205819836 |
| Entity Type | Individual |
| Full Name | GEORGE I CONKLIN |
| Credential | PA-C |
| Practice Address |
1405 California Ave Dos Palos CA 93620-2300 |
| Mailing Address |
737 W Childs Ave Merced CA 95341-6805 |
| Practice Telephone | 2093922111 |
| Practice Fax Number | 2093922850 |
| Mailing Telephone | 2093831848 |
| Mailing Fax Number | 2093843866 |
| Enumeration Date | 2005-11-29 |
| Last Update Date | 2011-12-27 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
PA13790 | CA | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | NCCPA CERT # | 1031166 | 01 |
| CA | DEA CERT # | MC0509111 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245215151 | George T Conklin | Internal Medicine | 1200 Binz St, Ste 700, Houston, TX 77004-6900 | 2005-12-13 |
| Street Address |
1405 CALIFORNIA AVE |
| City | DOS PALOS |
| State | CA |
| Zip Code | 93620-2300 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265969935 | Andrea Lesa Velasquez | Registered Nurse | 1405 California Ave, Dos Palos, CA 93620-2300 | 2017-05-12 |
| 1922460914 | Diana Huizar | Nurse Practitioner | 1405 California Ave, Dos Palos, CA 93620-2300 | 2016-03-28 |
| 1891073425 | Shannon Nicol Clasen | Nurse Practitioner | 1405 California Ave, Dos Palos, CA 93620-2300 | 2011-08-01 |
| 1952521759 | Golden Valley Health Centers | Family Medicine | 1405 California Ave, Dos Palos, CA 93620-2300 | 2007-04-26 |
| 1861612665 | Golden Valley Health Centers | Family Medicine | 1405 California Ave, Dos Palos, CA 93620-2300 | 2007-04-26 |
| 1770703571 | Golden Valley Health Center | Family Medicine | 1405 California Ave, Dos Palos, CA 93620-2300 | 2007-04-26 |
| 1689894487 | Golden Valley Health Centers | Family Medicine | 1405 California Ave, Dos Palos, CA 93620-2300 | 2007-04-26 |
| 1770567778 | Golden Valley Health Center | Clinic/Center | 1405 California Ave, Dos Palos, CA 93620-2300 | 2005-12-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215467824 | Simone Marie Goncalves | Counselor | 15728 Arroya Ave, Dos Palos, CA 93620 | 2017-06-15 |
| 1962681023 | Quantom Leap | Case Manager/Care Coordinator | 22368 S. 6th, South Dos Palos, CA 93620 | 2007-10-25 |
| 1265599401 | Dos Palos-oro Loma Jusd | Local Education Agency (LEA) | 2041 Almond St, Dos Palos, CA 93620-2303 | 2007-01-03 |
| 1003340605 | Stuart R. Schofield Dmd PC | Clinic/Center | 1402 California Ave, Dos Palos, CA 93620-2317 | 2017-04-20 |
| 1407071483 | Robert W Miller | Dentist | 1402 California Ave, Dos Palos, CA 93620-2317 | 2007-04-16 |
| 1942312939 | Dos Palos Drug Inc | Pharmacy | 1428 Center Ave, Dos Palos, CA 93620-2320 | 2006-08-31 |
| 1699139105 | George Randall Barsamian | Pharmacist | 1428 Center Ave, Dos Palos, CA 93620-2320 | 2016-04-11 |
| 1396960373 | Stuart R Schofield | Dentist | 1402 California Ave, Dos Palos, CA 93620-2321 | 2007-04-16 |
| 1831623453 | Dos Palos Apex Health Center Inc | Clinic/Center | 1549 Golden Gate St., Dos Palos, CA 93620-2329 | 2017-04-20 |
| 1619247574 | Yee Xiong | Physician Assistant | 1549 Golden Gate Ave, Dos Palos, CA 93620-2329 | 2012-01-10 |
| Find all providers in zip 93620 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760089437 | Karine Harutyunyan | Physician Assistant | 500 E Colorado St Ste 101, Glendale, CA 91205-1607 | 2020-10-06 |
| 1437756228 | Kale Burket | Physician Assistant | Bldg 523, S 8th St, El Centro, CA 92243 | 2020-10-05 |
| 1548867666 | Heba Marzouk Al-shoubaki | Physician Assistant | 633 S Pepper St, Anaheim, CA 92802-1459 | 2020-10-01 |
| 1275140550 | Lisa Lynn Passalacqua | Physician Assistant | 431 7th St, Norco, CA 92860-1671 | 2020-09-30 |
| 1144833989 | Trisha Taylor | Physician Assistant | 10399 Tivoli Way, Yucaipa, CA 92399-6017 | 2020-08-30 |
| 1457963944 | Harlan William Monahan | Physician Assistant | 5210 Del Rio Rd, Sacramento, CA 95822-2519 | 2020-08-18 |
| 1275144313 | Sofia Carmen Bustillo | Physician Assistant | 1709 Coral Pl, Seal Beach, CA 90740-5712 | 2020-08-12 |
| 1124638663 | Gayaneh Gharakhani | Physician Assistant | 1323 E Broadway Apt 110, Glendale, CA 91205-4018 | 2020-08-07 |
| 1144830183 | Loc Bao Tran | Physician Assistant | 8937 Emerson Pl, Rosemead, CA 91770-2813 | 2020-08-04 |
| 1558997957 | Sarah Lubinsky | Physician Assistant | 1511 Montana Ave, Santa Monica, CA 90403-1891 | 2020-03-17 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.