Provider Demographics
NPI:1689427601
Name:PIERRA, CONNER ERIC (DPT)
Entity Type:Individual
Prefix:
First Name:CONNER
Middle Name:ERIC
Last Name:PIERRA
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2820 N BELLFLOWER BLVD
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90815-1125
Mailing Address - Country:US
Mailing Address - Phone:562-384-4525
Mailing Address - Fax:562-384-4524
Practice Address - Street 1:2820 N BELLFLOWER BLVD
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90815-1125
Practice Address - Country:US
Practice Address - Phone:562-384-4525
Practice Address - Fax:562-384-4524
Is Sole Proprietor?:No
Enumeration Date:2024-04-09
Last Update Date:2024-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA305589225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist