Provider Demographics
NPI:1851753925
Name:CONRAD, DESIREE' (MD)
Entity type:Individual
Prefix:
First Name:DESIREE'
Middle Name:
Last Name:CONRAD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:750 WELCH ROAD
Mailing Address - Street 2:SUITE 305
Mailing Address - City:PALO ALTO
Mailing Address - State:CA
Mailing Address - Zip Code:94304-5731
Mailing Address - Country:US
Mailing Address - Phone:650-721-6849
Mailing Address - Fax:844-484-7926
Practice Address - Street 1:750 WELCH ROAD
Practice Address - Street 2:SUITE 305
Practice Address - City:PALO ALTO
Practice Address - State:CA
Practice Address - Zip Code:94304-5731
Practice Address - Country:US
Practice Address - Phone:650-721-6849
Practice Address - Fax:844-484-7926
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-28
Last Update Date:2020-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program