Provider Demographics
NPI:1568577955
Name:DANIEL R. CONLIN, M.D. & ROBERT J. ELSEN, M.D. A MEDICAL CORPORATION.
Entity Type:Organization
Organization Name:DANIEL R. CONLIN, M.D. & ROBERT J. ELSEN, M.D. A MEDICAL CORPORATION.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GENERAL PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:J
Authorized Official - Last Name:ELSEN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:415-863-5272
Mailing Address - Street 1:DEPT LA 22998
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91185-2998
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:45 CASTRO ST #437
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94114-1029
Practice Address - Country:US
Practice Address - Phone:415-863-5272
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-19
Last Update Date:2015-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG71096207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ10655ZMedicare ID - Type Unspecified