MEDICARE: DR. OFELIA CARATAO M.D.

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	208000000X	Pediatrics Physician	C50314	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	C50314	OTHER	CA	LICENSE

General Provider Information

NPI Number	:	1578537445
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. OFELIA CARATAO M.D.

Provider Business Mailing Address
First Line	:	600 W SHERYL CIR
Second Line	:
City	:	CARSON
State	:	CA
Zip	:	90745-5144
Country	:	US
Telephone Number	:	310-834-0419
Fax Number	:	310-326-3386

Provider Business Practice Location Address
First Line	:	2232 SEPULVEDA BLVD
Second Line	:
City	:	TORRANCE
State	:	CA
Zip	:	90501-5301
Country	:	US
Telephone Number	:	310-784-8131
Fax Number	:	310-326-3386

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

Provider Enumeration Date	:	02/15/2006
Last Update Date	:	10/17/2012

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