MEDICARE: DR. PATRICIA CARLTON PHARM.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	183500000X	Pharmacist	RPH37034	CA

General Provider Information

NPI Number	:	1760476683
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PATRICIA CARLTON PHARM.D.

Provider Business Mailing Address
First Line	:	2321 WINTERGREEN CT
Second Line	:
City	:	LODI
State	:	CA
Zip	:	95242-3651
Country	:	US
Telephone Number	:	209-339-0918
Fax Number	:

Provider Business Practice Location Address
First Line	:	1800 N CALIFORNIA ST
Second Line	:
City	:	STOCKTON
State	:	CA
Zip	:	95204-6019
Country	:	US
Telephone Number	:	209-461-5100
Fax Number	:

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

Provider Enumeration Date	:	09/07/2005
Last Update Date	:	07/08/2007

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