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General NPI Number Information
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NPI Number | 1003262304
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Entity Type | Organization
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Legal Business Name | DR. SHAUN CARPENTER, PC
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Dates
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Enumeration Date | 05/05/2016
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 16453 COLORADO AVE
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City | PARAMOUNT
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State | CA
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Zip | 90723-5011
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Country | US
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Telephone | 985-892-7070
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Fax | 985-892-7017
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Provider Business Mailing Address
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Address Line | PO BOX 1089
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City | HAMMOND
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State | LA
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Zip | 70404-1089
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Country | US
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Telephone | 985-892-7070
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Fax | 985-892-7017
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Authorized Official
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Title or Position | CAO
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Name | TASHA MEARS
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Credential | RN, BSN
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Telephone | 225-347-4975
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State |
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