Provider Demographics
NPI:1861668188
Name:ERLINDA UY-CONCEPCION M D INC
Entity Type:Organization
Organization Name:ERLINDA UY-CONCEPCION M D INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ERLINDA
Authorized Official - Middle Name:TO
Authorized Official - Last Name:UY-CONCEPCION
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:909-621-3573
Mailing Address - Street 1:536 E FOOTHILL BLVD
Mailing Address - Street 2:SUITE B
Mailing Address - City:UPLAND
Mailing Address - State:CA
Mailing Address - Zip Code:91786-3955
Mailing Address - Country:US
Mailing Address - Phone:909-981-5882
Mailing Address - Fax:909-385-0379
Practice Address - Street 1:536 E FOOTHILL BLVD
Practice Address - Street 2:SUITE B
Practice Address - City:UPLAND
Practice Address - State:CA
Practice Address - Zip Code:91786-3955
Practice Address - Country:US
Practice Address - Phone:909-981-5882
Practice Address - Fax:909-385-0379
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-06
Last Update Date:2008-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA29880207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1194742775OtherINDIVIDUAL NPI - TYPE 1
CA00A29880Medicaid
CA00A298800Medicare PIN
CA00A29880Medicaid