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NPI Code Detail

MEDICARE: CARBON HEALTH MEDICAL GROUP OF CALIFORNIA PC

MEDICARE: CARBON HEALTH MEDICAL GROUP OF CALIFORNIA PC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine Physician
2261QU0200XUrgent Care Clinic/Center
3261QM1300XMulti-Specialty Clinic/Center

General Provider Information

NPI Number : 1043852999
Entity Type Code : Organization
Provider Name (Legal Business Name) : CARBON HEALTH MEDICAL GROUP OF CALIFORNIA PC
Provider Business Mailing Address
First Line : 300 CALIFORNIA AVE FL
Second Line :
City : SAN FRANCISCO
State : CA
Zip : 94130-1708
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 4150 N 1ST ST
Second Line :
City : SAN JOSE
State : CA
Zip : 95134-1513
Country : US
Telephone Number : 669-200-4558
Fax Number :
Authorized Official
Title or Position : DIRECTOR
Name : MARLEY PAGE
Credential :
Telephone Number : 303-601-5392
Provider Enumeration Date : 10/11/2019
Last Update Date : 06/25/2025

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