Healthcare Provider Details

I. General information

NPI: 1265400550
Provider Name (Legal Business Name): CARLO Z BISCARO MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/10/2006
Last Update Date: 02/28/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1220 HEMLOCK WAY STE 200
SANTA ANA CA
92707-3655
US

IV. Provider business mailing address

1220 HEMLOCK WAY STE 200
SANTA ANA CA
92707-3655
US

V. Phone/Fax

Practice location:
  • Phone: 714-751-0101
  • Fax: 714-545-2762
Mailing address:
  • Phone: 714-751-0101
  • Fax: 714-545-2762

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License NumberC39064
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: