MEDICARE: SAMUEL WILLIAM CARNEY

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	207PE0004X	Emergency Medical Services (Emergency Medicine) Physician	E193949	CA

General Provider Information

NPI Number	:	1447196241
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SAMUEL WILLIAM CARNEY

Provider Business Mailing Address
First Line	:	1510 ROLLINS RD
Second Line	:
City	:	BURLINGAME
State	:	CA
Zip	:	94010-2306
Country	:	US
Telephone Number	:	650-235-1333
Fax Number	:

Provider Business Practice Location Address
First Line	:	1510 ROLLINS RD
Second Line	:
City	:	BURLINGAME
State	:	CA
Zip	:	94010-2306
Country	:	US
Telephone Number	:	650-235-1333
Fax Number	:

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

Provider Enumeration Date	:	04/25/2026
Last Update Date	:	04/25/2026

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