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NPI Code Detail

MEDICARE: CARLOS ADRIAN NEVAREZ ONTIVEROS MD

MEDICARE:   CARLOS ADRIAN NEVAREZ ONTIVEROS  MD
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
1246ZC0007XSurgical Assistant238.000403IL
2390200000XStudent in an Organized Health Care Education/Training Program

General Provider Information

NPI Number : 1336542869
Entity Type Code : Individual
Provider Name (Legal Business Name) : CARLOS ADRIAN NEVAREZ ONTIVEROS MD
Provider Business Mailing Address
First Line : 1150 N PALM CANYON DR
Second Line :
City : PALM SPRINGS
State : CA
Zip : 92262-4402
Country : US
Telephone Number : 415-623-4571
Fax Number :
Provider Business Practice Location Address
First Line : 1150 N PALM CANYON DR
Second Line :
City : PALM SPRINGS
State : CA
Zip : 92262-4402
Country : US
Telephone Number : 415-623-4571
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/29/2014
Last Update Date : 04/26/2023

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Directions to “ CARLOS ADRIAN NEVAREZ ONTIVEROS MD” Practice Location

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