Healthcare Provider Details

I. General information

NPI: 1932159829
Provider Name (Legal Business Name): RICHARD D. CARVOLTH MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/11/2006
Last Update Date: 07/10/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5000 HOPYARD RD SUITE 100
PLEASANTON CA
94588-3348
US

IV. Provider business mailing address

5000 HOPYARD RD SUITE 100
PLEASANTON CA
94588-3348
US

V. Phone/Fax

Practice location:
  • Phone: 925-924-1600
  • Fax: 925-924-0506
Mailing address:
  • Phone: 925-924-1600
  • Fax: 925-924-0601

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberG39595
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: