Carlson, Carl Jeffrey
Carlson, Carl Jeffrey is an sole proprietor health care provider with primary practice located at 2333 Mowry Ave Suite 220, Fremont CA 94538-1700. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Cardiovascular Disease, Allopathic & Osteopathic Physicians / Interventional Cardiology. Allopathic & Osteopathic Physicians / Cardiovascular Disease is his primary health care specialty. Carlson, Carl Jeffrey can be contacted via phone (510) 792-2012.Contact Information
Primary practice address
2333 Mowry Ave Suite 220
Fremont CA 94538-1700
Phone: (510) 792-2012
Fax: (510) 792-7986
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Cardiovascular Disease | 207RC0000X | G29295 | California |
| Allopathic & Osteopathic Physicians / Interventional Cardiology | 207RI0011X | G29295 | California |
Profile Details
| NPI number | 1386669489 |
|---|---|
| LBN Legal business name | Carlson, Carl Jeffrey |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jul 12th, 2006 |
| Last updated | Mar 18th, 2011 - about 13 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1386669489 | NPPES |
| California | Other | 060006330 | RAILROAD MEDICARE |
| California | Other | A44008 | RAILROAD MEDICARE |
| California | MEDICAID | 00G292950 | RAILROAD MEDICARE |
| California | Other | 00G292950 | RAILROAD MEDICARE |
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