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General NPI Number Information
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NPI Number | 1164429965
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Entity Type | Individual
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Provider Name | JOHN R CARLSON M.D
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Gender | Male
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Dates
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Enumeration Date | 07/07/2005
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Last Update Date | 08/14/2022
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Provider Practice Location Address
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Address Line | 1083 LOS PALOS DR
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City | SALINAS
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State | CA
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Zip | 93901-3916
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Country | US
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Telephone | 831-771-1456
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Fax | 831-783-3124
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Provider Business Mailing Address
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Address Line | 1081 LOS PALOS DR B
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City | SALINAS
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State | CA
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Zip | 93901-3916
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Country | US
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Telephone | 831-771-1456
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Fax | 831-783-3124
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | G40653
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License Number State | CA
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