Healthcare Provider Details

I. General information

NPI: 1346570124
Provider Name (Legal Business Name): JEFFREY D CARTER MD INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/30/2009
Last Update Date: 06/22/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21 UPPER RAGSDALE DR SUITE 100
MONTEREY CA
93940-7831
US

IV. Provider business mailing address

21 UPPER RAGSDALE DR SUITE 100
MONTEREY CA
93940-7831
US

V. Phone/Fax

Practice location:
  • Phone: 831-648-8020
  • Fax: 831-648-8023
Mailing address:
  • Phone: 831-648-8020
  • Fax: 831-648-8023

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207XX0005X
TaxonomySports Medicine (Orthopaedic Surgery) Physician
License Number00G525640
License Number StateCA

VIII. Authorized Official

Name: NICHOLE GUZMAN
Title or Position: OFFICE MANAGER
Credential:
Phone: 831-648-8020