MEDICARE: CARLOS PAZ MD, PHD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207NS0135X	Procedural Dermatology Physician	A 121126	CA

General Provider Information

NPI Number	:	1275885709
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CARLOS PAZ MD, PHD

Provider Business Mailing Address
First Line	:	7025 N CHESTNUT AVE
Second Line	:	STE. 105
City	:	FRESNO
State	:	CA
Zip	:	93720-0351
Country	:	US
Telephone Number	:	559-233-3376
Fax Number	:	559-233-6647

Provider Business Practice Location Address
First Line	:	7025 N CHESTNUT AVE
Second Line	:	STE. 105
City	:	FRESNO
State	:	CA
Zip	:	93720-0351
Country	:	US
Telephone Number	:	559-233-3376
Fax Number	:	559-233-6647

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/08/2012
Last Update Date	:	05/05/2015

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