Healthcare Provider Details

I. General information

NPI: 1083052021
Provider Name (Legal Business Name): CAROLINA ISABEL GALARRETA AIMA M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: CAROLINA ISABEL GALARRETA MD

II. Dates (important events)

Enumeration Date: 06/12/2013
Last Update Date: 03/11/2020
Certification Date: 03/11/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9300 VALLEY CHILDRENS PL # GE21
MADERA CA
93636-8762
US

IV. Provider business mailing address

9300 VALLEY CHILDRENS PL # SC05
MADERA CA
93636-8762
US

V. Phone/Fax

Practice location:
  • Phone: 559-353-6400
  • Fax: 559-353-7213
Mailing address:
  • Phone: 559-353-5700
  • Fax: 559-353-5708

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License NumberTRN18587
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code207SG0201X
TaxonomyClinical Genetics (M.D.) Physician
License NumberA143594
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: