Provider Demographics
NPI:1376864215
Name:ALCONCEL, KATHERINE NANDOR (DO)
Entity Type:Individual
Prefix:DR
First Name:KATHERINE
Middle Name:NANDOR
Last Name:ALCONCEL
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
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Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:4000 CIVIC CENTER DR
Mailing Address - Street 2:STE 206
Mailing Address - City:SAN RAFAEL
Mailing Address - State:CA
Mailing Address - Zip Code:94903-5233
Mailing Address - Country:US
Mailing Address - Phone:769-946-4233
Mailing Address - Fax:
Practice Address - Street 1:18300 US HIGHWAY 18
Practice Address - Street 2:SOUND PHYSICIANS
Practice Address - City:APPLE VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92307-2206
Practice Address - Country:US
Practice Address - Phone:769-946-4233
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-06-15
Last Update Date:2022-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A12724207R00000X
NVDO3123207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine