Calder Bryce Conner, MD
Individual provider Active NPI Emergency Medicine Physician · San Leandro, CA
NPI 1770537433 · NPPES record last updated Jul 27, 2023
Key facts
- NPI
- 1770537433
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Emergency Medicine Physician 207P00000X
- License
- 4301102402 (MI)
- Practice address
- 2587 Merced St
San Leandro, CA 94577-4207 - Phone
- (510) 351-3553
- Fax
- (510) 351-3585
- NPI assigned
- May 19, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 8
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MI
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20130824000236 | MI | Practitioner - Emergency Medicine | 1052327095 | Reassigns benefits to 3 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- No
- HHS exclusion list flag
- The National Provider Directory flags this NPI as appearing on an HHS exclusion list.
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| G54830 | CA | MD | General Practice Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Adrian Urgent Care PLLC | Current |
Accepting new patients | |
| Southgate Urgent Care PC | Current |
Accepting new patients | |
| Warren Urgent Care PC | Current |
Accepting new patients | |
| Woodland Urgent Care LLC | Current |
Accepting new patients | |
| Southgate Urgent Care PC | Past |
Accepting new patients | |
| Rioh Medical Group | General Practice | Past |
Accepting new patients |
| Warren Urgent Care PC | Past |
Accepting new patients | |
| Adrian Urgent Care PLLC | Past |
Accepting new patients |
Locations
715 N Main St
Adrian, MI 49221
Phone (248) 957-7999
22341 W 8 Mile Rd
Detroit, MI 48219
Phone (313) 326-4989
34405 W 12 Mile Rd
Ste 205
Farmington Hills, MI 48331
Phone (248) 880-6225
14523 Northline Rd
Southgate, MI 48195
Phone (734) 324-7800
31700 Van Dyke Ave
Warren, MI 48093
Phone (586) 276-8130
L4372
Columbus, OH 43260
L4380
Columbus, OH 43260
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Physician | 208D00000X | G54830 | CA | |
| Emergency Medicine Physician | 207P00000X | 4301102402 | MI | Yes |
Addresses
Primary practice location
2587 Merced St
San Leandro, CA 94577-4207
Mailing address
699 Lewelling Blvd
Suite 146-337
San Leandro, CA 94579-1870
Phone (510) 504-9660
Other providers in San Leandro, CA
- Keyerra Comford
- Community Dental Services
- Community Health Center Network
- Community Mobile Diagnostics LLC
- Concentra Health Services, Inc.
- Rachel Connolly
- Ryan Matthew Conrad
- Belen Contreras Cervantes
- Alicia Contreras
- Mary Mapelli Conway
All providers in San Leandro, CA · Emergency Medicine Physician in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 27, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.