Carrillo, Carrie M
Carrillo, Carrie M is an individual health care provider with primary practice located at 2141 N Harbor Blvd Ste 35000 , Fullerton CA 92835-3831. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Surgical, which is considered as her primary health care specialty. Carrillo, Carrie M can be contacted via phone (714) 626-8630.Contact Information
Primary practice address
2141 N Harbor Blvd Ste 35000
Fullerton CA 92835-3831
Phone: (714) 626-8630
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Surgical | 363AS0400X | PA17561 | California |
Profile Details
| NPI number | 1588872089 |
|---|---|
| LBN Legal business name | Carrillo, Carrie M |
| Credentials | Physician Assistant (PA) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 18th, 2007 |
| Last updated | Oct 20th, 2021 - about 3 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 | 1588872089 | NPPES |
| California | Other | PA17561 | LICENSE |
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