Healthcare Provider Details

I. General information

NPI: 1760793160
Provider Name (Legal Business Name): CHERYL CARANDANG NOCON M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CHERYL CARANDANG

II. Dates (important events)

Enumeration Date: 06/30/2010
Last Update Date: 04/01/2024
Certification Date: 03/28/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1701 E CESAR CHAVEZ AVENUE SUITE 560
LOS ANGELES CA
90033
US

IV. Provider business mailing address

1701 E CESAR CHAVEZ AVENUE SUITE 560
LOS ANGELES CA
90033
US

V. Phone/Fax

Practice location:
  • Phone: 323-226-0022
  • Fax: 323-488-9546
Mailing address:
  • Phone: 323-226-0022
  • Fax: 323-488-9546

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License Number036139519
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: