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General NPI Number Information
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NPI Number | 1720572274
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Entity Type | Organization
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Legal Business Name | DAVID CARREON MD INC
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Dates
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Enumeration Date | 06/19/2018
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Last Update Date | 10/21/2024
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Provider Practice Location Address
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Address Line | 877 W FREMONT AVE STE N3
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City | SUNNYVALE
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State | CA
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Zip | 94087-2332
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Country | US
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Telephone | 650-993-9996
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Fax | 650-999-0939
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Provider Business Mailing Address
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Address Line | 877 W FREMONT AVE STE J1
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City | SUNNYVALE
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State | CA
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Zip | 94087-2332
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Country | US
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Telephone | 650-993-9996
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Fax | 650-999-0939
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. DAVID MIKEL CARREON
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Credential | MD
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Telephone | 650-993-9996
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | A138528
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License Number State | CA
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