Provider Demographics
NPI:1477209302
Name:CONBOY, SAMANTHA (CCH)
Entity Type:Individual
Prefix:
First Name:SAMANTHA
Middle Name:
Last Name:CONBOY
Suffix:
Gender:F
Credentials:CCH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3941 ARDMORE DR
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92111-3404
Mailing Address - Country:US
Mailing Address - Phone:760-519-0703
Mailing Address - Fax:
Practice Address - Street 1:3941 ARDMORE DR
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92111-3404
Practice Address - Country:US
Practice Address - Phone:760-519-0703
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-01
Last Update Date:2022-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175L00000XOther Service ProvidersHomeopath