=====================================================
General NPI Number Information
=====================================================
NPI Number | 1447458963
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | CAMEO ASHLEY CARTER M.D.
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/05/2007
-----------------------------------------------------
Last Update Date | 12/05/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 470 E HIGHLAND AVE
-----------------------------------------------------
City | REDLANDS
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 92373-6826
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 909-792-8866
-----------------------------------------------------
Fax | 909-792-9395
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 470 E HIGHLAND AVE
-----------------------------------------------------
City | REDLANDS
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 92373-6826
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 909-792-8866
-----------------------------------------------------
Fax | 909-792-9395
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 2083B0002X
-----------------------------------------------------
Taxonomy Name | Obesity Medicine (Preventive Medicine) Physician
-----------------------------------------------------
License Number | A94105
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 208000000X
-----------------------------------------------------
Taxonomy Name | Pediatrics Physician
-----------------------------------------------------
License Number | A94105
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------