Carrillo Medical Group Professional Corporation

LBN: Carrillo Medical Group Professional Corporation
Carrillo Medical Group Professional Corporation is an health care organization with primary practice located at 1800 Sullivan Ave Rm 101 , Daly City CA 94015-2227. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as the primary health care specialty. Carrillo Medical Group Professional Corporation can be contacted via phone (650) 994-0459, or through Sjogrell, Ines via phone (925) 790-0760.

Contact Information

Primary practice address
1800 Sullivan Ave Rm 101 Daly City CA 94015-2227
Phone: (650) 994-0459
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Sjogrell, Ines
Phone: (925) 790-0760

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X A51743 California

Profile Details

NPI number 1730223421
LBN Legal business name Carrillo Medical Group Professional Corporation
DBA Doing business as
Authorized official Sjogrell, Ines
Entity Organization
Organization subpart 1 No
Enumeration date Feb 16th, 2007
Last updated Sep 15th, 2015 - about 9 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1730223421 NPPES
California MEDICAID 00A517430

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