Provider Demographics
NPI:1164442257
Name:CONNER, ERIC S (MD)
Entity Type:Individual
Prefix:
First Name:ERIC
Middle Name:S
Last Name:CONNER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 20577
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93390-0577
Mailing Address - Country:US
Mailing Address - Phone:661-477-9283
Mailing Address - Fax:661-326-8022
Practice Address - Street 1:400 OLD RIVER RD
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93311-9781
Practice Address - Country:US
Practice Address - Phone:661-477-9283
Practice Address - Fax:661-326-8022
Is Sole Proprietor?:No
Enumeration Date:2006-07-20
Last Update Date:2007-08-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA84828207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A848280Medicaid
CA00A848280Medicare PIN
CA00A848280Medicaid