Jose Luis Condor

Primary specialty

SpecialistTaxonomy code 174400000X

Practice address

4610 X St
Sacramento, CA 95817-2200

Phone

(562) 489-6122

NPI assigned

Apr 25, 2024

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1714003200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747785600000",
    "number": "1053167668",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3116 2ND AVE APT C",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958172759",
            "telephone_number": "562-489-6122"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4610 X ST",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958172200",
            "telephone_number": "562-489-6122"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONDOR",
        "first_name": "JOSE",
        "middle_name": "LUIS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-04-25",
        "last_updated": "2025-05-21",
        "certification_date": "2025-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Catherine M Comroe, PNP
• David Conard, CMP
• Erin Bridget Conboy Heiser, RN
• Concentra Health Centers, Inc.
• Andie Conching
• Bryan Cone
• Logan Cone, DO
• Erica Monique Maxine Conley
• Gabriel Conley
• Jaela Conley

• Specialist in Sacramento, CA
• Providers in Sacramento, CA by specialty
• Specialist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.