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NPI Code Detail

MEDICARE: CARLA DOSS

MEDICARE: CARLA DOSS
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
1171M00000XCase Manager/Care Coordinator

General Provider Information

NPI Number : 1801926480
Entity Type Code : Individual
Provider Name (Legal Business Name) : CARLA DOSS
Provider Business Mailing Address
First Line : 2951 GRAMERCY ST
Second Line :
City : POMONA
State : CA
Zip : 91767-1819
Country : US
Telephone Number : 909-596-7405
Fax Number :
Provider Business Practice Location Address
First Line : 23701 E EAST FORK RD
Second Line :
City : AZUSA
State : CA
Zip : 91702-1477
Country : US
Telephone Number : 626-250-3300
Fax Number : 626-910-1380
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/06/2007
Last Update Date : 08/05/2011

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Directions to “ CARLA DOSS ” Practice Location

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