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General NPI Number Information
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NPI Number | 1194854067
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Entity Type | Individual
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Provider Name | JONATHAN TODD CARTER M.D.
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Gender | Male
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Dates
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Enumeration Date | 03/05/2007
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Last Update Date | 12/26/2012
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Provider Practice Location Address
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Address Line | 513 PARNASSUS AVE RM S-321 UCSF DEPARTMENT OF SURGERY
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City | SAN FRANCISCO
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State | CA
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Zip | 94143-0470
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Country | US
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Telephone | 415-514-3891
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Fax |
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Provider Business Mailing Address
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Address Line | 1716 LEXINGTON AVE
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City | SAN MATEO
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State | CA
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Zip | 94402-4025
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Country | US
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Telephone | 415-577-4564
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Fax |
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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 | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | A77227
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License Number State | CA
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