Healthcare Provider Details

I. General information

NPI: 1891577532
Provider Name (Legal Business Name): CARBON HEALTH MEDICAL GROUP OF CALIFORNIA PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/17/2023
Last Update Date: 06/24/2025
Certification Date: 06/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 E COLORADO BLVD STE 120
PASADENA CA
91101-6800
US

IV. Provider business mailing address

2100 FRANKLIN ST STE 355
OAKLAND CA
94612-3140
US

V. Phone/Fax

Practice location:
  • Phone: 323-301-7988
  • Fax:
Mailing address:
  • Phone: 415-446-1733
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332900000X
TaxonomyNon-Pharmacy Dispensing Site
License Number
License Number State

VIII. Authorized Official

Name: MARLEY PAGE
Title or Position: DIRECTOR
Credential:
Phone: 417-861-9739