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General NPI Number Information
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NPI Number | 1497847198
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Entity Type | Individual
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Provider Name | DENEEN CHERRY DICARLO MD
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Gender | Female
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Dates
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Enumeration Date | 09/29/2006
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Last Update Date | 09/27/2018
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Provider Practice Location Address
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Address Line | 77 CASA ST STE 101
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City | SAN LUIS OBISPO
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State | CA
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Zip | 93405-5804
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Country | US
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Telephone | 661-695-8385
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Fax | 805-439-2765
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Provider Business Mailing Address
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Address Line | 8329 BRIMHALL RD SUITE 801
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City | BAKERSFIELD
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State | CA
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Zip | 93312-2243
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Country | US
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Telephone | 661-695-8385
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Fax | 805-439-2765
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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 | 207RR0500X
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Taxonomy Name | Rheumatology Physician
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License Number | A98771
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License Number State | CA
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