Provider Demographics
NPI:1881562296
Name:CONROY, KEVIN (COA)
Entity type:Individual
Prefix:
First Name:KEVIN
Middle Name:
Last Name:CONROY
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Gender:M
Credentials:COA
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Mailing Address - Street 1:11301 WILSHIRE BLVD BLDG 304
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90073-1003
Mailing Address - Country:US
Mailing Address - Phone:310-268-3396
Mailing Address - Fax:310-268-4918
Practice Address - Street 1:11301 WILSHIRE BLVD BLDG 304
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90073-1003
Practice Address - Country:US
Practice Address - Phone:310-268-3396
Practice Address - Fax:310-268-4918
Is Sole Proprietor?:No
Enumeration Date:2025-10-27
Last Update Date:2025-10-27
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1101XEye and Vision Services ProvidersTechnician/TechnologistOphthalmic Assistant