Healthcare Provider Details

I. General information

NPI: 1366752107
Provider Name (Legal Business Name): CAROLINA SUELDO M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/14/2010
Last Update Date: 02/25/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

729 N MEDICAL CENTER DR W STE 205
CLOVIS CA
93611-6885
US

IV. Provider business mailing address

729 N MEDICAL CENTER DR W STE 205
CLOVIS CA
93611-6885
US

V. Phone/Fax

Practice location:
  • Phone: 559-299-7700
  • Fax: 559-297-9679
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberME123211
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number051012
License Number StateCT
# 3
Primary TaxonomyY
Taxonomy Code207VE0102X
TaxonomyReproductive Endocrinology Physician
License NumberA113893
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: