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NPI Code Detail

MEDICARE: DR. CAROL A AHERN MD

MEDICARE: DR. CAROL A AHERN MD
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
1207Q00000XFamily Medicine PhysicianG80132CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1760546915
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. CAROL A AHERN MD
Provider Business Mailing Address
First Line : 19270 HIGHWAY 12
Second Line :
City : SONOMA
State : CA
Zip : 95476-5414
Country : US
Telephone Number : 707-939-6070
Fax Number :
Provider Business Practice Location Address
First Line : 19270 HIGHWAY 12
Second Line :
City : SONOMA
State : CA
Zip : 95476-5414
Country : US
Telephone Number : 707-939-6070
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/21/2006
Last Update Date : 07/23/2014

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