Provider Demographics
NPI:1922230887
Name:CONKLING, DONALD BRIAN (DVM)
Entity Type:Individual
Prefix:DR
First Name:DONALD
Middle Name:BRIAN
Last Name:CONKLING
Suffix:
Gender:M
Credentials:DVM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:805 MASSON AVE
Mailing Address - Street 2:
Mailing Address - City:SAN BRUNO
Mailing Address - State:CA
Mailing Address - Zip Code:94066-3133
Mailing Address - Country:US
Mailing Address - Phone:650-952-6454
Mailing Address - Fax:650-871-8185
Practice Address - Street 1:805 MASSON AVE
Practice Address - Street 2:
Practice Address - City:SAN BRUNO
Practice Address - State:CA
Practice Address - Zip Code:94066-3133
Practice Address - Country:US
Practice Address - Phone:650-952-6454
Practice Address - Fax:650-871-8185
Is Sole Proprietor?:No
Enumeration Date:2009-08-11
Last Update Date:2009-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA5967174M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174M00000XOther Service ProvidersVeterinarian