MEDICARE: ROBERTO CARPIO

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
1	363LF0000X	Family Nurse Practitioner	NP95000068	CA

General Provider Information

NPI Number	:	1215337084
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROBERTO CARPIO

Provider Business Mailing Address
First Line	:	9427 LEMONA AVE UNIT 31
Second Line	:
City	:	NORTH HILLS
State	:	CA
Zip	:	91343-3546
Country	:	US
Telephone Number	:	213-344-6332
Fax Number	:	818-892-4952

Provider Business Practice Location Address
First Line	:	9427 LEMONA AVE UNIT 31
Second Line	:
City	:	NORTH HILLS
State	:	CA
Zip	:	91343-3546
Country	:	US
Telephone Number	:	213-344-6332
Fax Number	:	818-892-4952

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/29/2014
Last Update Date	:	08/29/2014

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Directions to “ ROBERTO CARPIO ” Practice Location

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