MEDICARE: CARLOS M FIGUEROA, MD, A PROFESSIONAL CORPORATION

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	2084P0800X	Psychiatry Physician	G44673	CA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	00WG44673A	OTHER	CA	MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	1760499511	OTHER	CA	INDIVIDUAL NPI
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1265714349
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CARLOS M FIGUEROA, MD, A PROFESSIONAL CORPORATION

Provider Business Mailing Address
First Line	:	1118 E GREEN ST
Second Line	:
City	:	PASADENA
State	:	CA
Zip	:	91106-2500
Country	:	US
Telephone Number	:	626-795-5156
Fax Number	:	626-795-5013

Provider Business Practice Location Address
First Line	:	1118 E GREEN ST
Second Line	:
City	:	PASADENA
State	:	CA
Zip	:	91106-2500
Country	:	US
Telephone Number	:	626-795-5156
Fax Number	:	626-795-5013

Authorized Official
Title or Position	:	OWNER
Name	:	DR. CARLOS M FIGUEROA
Credential	:	MD
Telephone Number	:	626-795-5156

Provider Enumeration Date	:	09/14/2011
Last Update Date	:	09/14/2011

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