Healthcare Provider Details

I. General information

NPI: 1891982633
Provider Name (Legal Business Name): CINDY ALBERTS CARSON MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/25/2007
Last Update Date: 01/29/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

960 E GREEN ST SUITE 104
PASADENA CA
91106-2412
US

IV. Provider business mailing address

439 S MERIDITH AVE
PASADENA CA
91106-3512
US

V. Phone/Fax

Practice location:
  • Phone: 626-793-9353
  • Fax: 626-793-9315
Mailing address:
  • Phone: 626-793-9353
  • Fax: 626-793-9315

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberA101515
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: