Individual provider Active NPI

Ralph E Conner III, DO

  • Emergency Medicine Physician
  • Anaheim, CA
National Provider Identifier
1114941812
Registry record updated Dec 2, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
20A6547 Issued in CA
Practice address
3350 W Ball Rd
Anaheim, CA 92804-3710
Phone
(714) 220-4533
Fax
(818) 587-2493
NPI assigned
Jul 26, 2006
Last updated
Dec 2, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 2, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 20A6547 CA Primary

Addresses

Primary practice location

3350 W Ball Rd
Anaheim, CA 92804-3710

Mailing address

PO Box 4419
Woodland Hills, CA 91365-4419
Phone (818) 340-9988

Other identifiers 2

IdentifierTypeStateIssuer
020A65470OtherCABLUE SHIELD
00AX65470MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040319001166 CA Practitioner - General PracticePractitioner - Emergency Medicine 4385534429 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
General PracticeAlso: Emergency Medicine
Education
College of Osteo Med of the Pacific at Pomona, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Gem Medical Group CorporationGroup PAC ID 3072984400, 54 clinicians

Practice addresses (Care Compare)

525 N Garfield Ave
Monterey Park, CA 91754-1202
Phone (626) 573-2222

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

Practice roles

OrganizationSpecialtyStatusNew patients
Anaheim Emergency Medical Group Emergency Medicine CurrentSince May 1, 2023 Accepting new patients
Montclair Emergency Medical Associates Emergency Medicine CurrentSince Sep 1, 2006 Accepting new patients
Gem Medical Group Corporation Emergency Medicine CurrentSince Mar 1, 2023 Accepting new patients
Gem Medical Group Corporation Emergency Medicine CurrentSince Mar 1, 2023 Accepting new patients
San Dimas Emergency Medical Associates Inc. Emergency Medicine CurrentSince Jan 1, 2015 Accepting new patients
Spectrum Emergency Physicians Group Inc. Emergency Medicine CurrentSince Apr 1, 2021 Accepting new patients
Ralph E Conner D.O. Inc PastSince Feb 27, 2001 Accepting new patients

Locations

1111 W La Palma Ave
Anaheim, CA 92801
Phone (714) 774-1450

5000 San Bernardino St
Montclair, CA 91763
Phone (909) 625-4111

525 N Garfield Ave
Monterey Park, CA 91754
Phone (626) 573-2222

900 S Atlantic Blvd
Monterey Park, CA 91754
Phone (626) 457-7450

Dept LA 25308
Pasadena, CA 91185

1350 W Covina Blvd
San Dimas, CA 91773
Phone (909) 394-2745

1701 Santa Anita Ave
South El Monte, CA 91733
Phone (626) 350-7916

9080 Colima Rd
Whittier, CA 90605
Phone (562) 907-1565

4401 W Memorial Rd
Ste 121
Oklahoma City, OK 73134
Phone (405) 749-4560

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1153872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1322784000000",
    "number": "1114941812",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4419",
            "city": "WOODLAND HILLS",
            "state": "CA",
            "postal_code": "913654419",
            "telephone_number": "818-340-9988",
            "fax_number": "818-587-2493"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3350 W BALL RD",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928043710",
            "telephone_number": "714-220-4533",
            "fax_number": "818-587-2493"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONNER",
        "first_name": "RALPH",
        "middle_name": "E",
        "name_suffix": "III",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-26",
        "last_updated": "2011-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "20A6547",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "020A65470",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00AX65470",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Anaheim, CA

Sources for this page

Verify at the official NPI Registry.