Omar Concepcion, MD
Individual provider Active NPI Student in an Organized Health Care Education/Training Program · Sanjuan, PR
NPI 1518421908 · NPPES record last updated Jul 27, 2022
Key facts
- NPI
- 1518421908
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Student in an Organized Health Care Education/Training Program 390200000X
- License
- 36124R
- Practice address
- Centro Medico
Sanjuan, PR 00927 - Phone
- (787) 518-5702
- NPI assigned
- Jan 30, 2019
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 35625 | PR | MD | General Practice Physician |
| 36124R | PR | MD | Student in an Organized Health Care Education/Training Program |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Physician | 208D00000X | 35625 | PR | |
| Student in an Organized Health Care Education/Training Program | 390200000X | 36124R | PR | |
| Student in an Organized Health Care Education/Training Program | 390200000X | 36124R | Yes |
Addresses
Primary practice location
Centro Medico
Sanjuan, PR 00927
Mailing address
HC 33 Box 2003
Dorado, PR 00646-9701
Other providers in Sanjuan, PR
- Milena Carcache
- Catala Eye Care LLC
- Cristian Brian Delgado Baez
- Ruben Fenollal Rodriguez
- Wilda Garrastegui
- Yolanda Ivette Huertas
- JCPK Endo LLC
All providers in Sanjuan, PR · Student in an Organized Health Care Education/Training Program in Puerto Rico
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 27, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.