Thomas Conklin

Primary specialty

Adult Medicine PhysicianTaxonomy code 207QA0505X

License

G44486 Issued in CA

Legal business name

THOMAS CONKLIN

Practice address

18417 Nordhoff St
Suite 8
Northridge, CA 91325-2200

Phone

(310) 348-0500

NPI assigned

Apr 10, 2007

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Steven Garrett, M.D.

Title

Billing Manager

Phone

(310) 348-0500

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1176163200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1497878706",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18417 NORDHOFF ST",
            "address_2": "SUITE 8",
            "city": "NORTHRIDGE",
            "state": "CA",
            "postal_code": "913252200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18417 NORDHOFF ST",
            "address_2": "SUITE 8",
            "city": "NORTHRIDGE",
            "state": "CA",
            "postal_code": "913252200",
            "telephone_number": "310-348-0500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THOMAS CONKLIN",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-10",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "GARRETT",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_title_or_position": "BILLING MANAGER",
        "authorized_official_telephone_number": "310-348-0500",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207QA0505X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine, Adult Medicine",
            "state": "CA",
            "license": "G44486",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G444850",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Adult Medicine Physician in Northridge, CA
• Providers in Northridge, CA by specialty
• Adult Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.