Provider Demographics
NPI:1033839865
Name:CAMIT, CONRAD JOSEPH
Entity Type:Individual
Prefix:MR
First Name:CONRAD
Middle Name:JOSEPH
Last Name:CAMIT
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2200 LEAVENWORTH ST APT 304
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94133-2277
Mailing Address - Country:US
Mailing Address - Phone:713-582-3460
Mailing Address - Fax:
Practice Address - Street 1:15750 FOOTHILL BLVD
Practice Address - Street 2:
Practice Address - City:SAN LEANDRO
Practice Address - State:CA
Practice Address - Zip Code:94578-1012
Practice Address - Country:US
Practice Address - Phone:510-667-3950
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-31
Last Update Date:2022-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program