Basic Information
| Provider Information | |||||||||
| NPI: | 1861668188 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | ERLINDA UY-CONCEPCION M D INC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 536 E FOOTHILL BLVD | ||||||||
| Address2: | SUITE B | ||||||||
| City: | UPLAND | ||||||||
| State: | CA | ||||||||
| PostalCode: | 917863955 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9099815882 | ||||||||
| FaxNumber: | 9093850379 | ||||||||
| Practice Location | |||||||||
| Address1: | 536 E FOOTHILL BLVD | ||||||||
| Address2: | SUITE B | ||||||||
| City: | UPLAND | ||||||||
| State: | CA | ||||||||
| PostalCode: | 917863955 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9099815882 | ||||||||
| FaxNumber: | 9093850379 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/06/2008 | ||||||||
| LastUpdateDate: | 09/18/2008 | ||||||||
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| AuthorizedOfficialLastName: | UY-CONCEPCION | ||||||||
| AuthorizedOfficialFirstName: | ERLINDA | ||||||||
| AuthorizedOfficialMiddleName: | TO | ||||||||
| AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
| AuthorizedOfficialTelephone: | 9096213573 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | M.D. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RN0300X | A29880 | CA | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine | Nephrology |
ID Information
| ID | Type | State | Issuer | Description | 1194742775 | 01 | CA | INDIVIDUAL NPI - TYPE 1 | OTHER | 00A29880 | 05 | CA | MEDICAID |