MEDICARE: CARLA MARIA PEREDO ALCID 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
1	208000000X	Pediatrics Physician	33113	KY
2	2080P0204X	Pediatric Emergency Medicine (Pediatrics) Physician	33113	KY
3	2080P0204X	Pediatric Emergency Medicine (Pediatrics) Physician	202409	LA
4	208000000X	Pediatrics Physician	202409	LA
5	207PP0204X	Pediatric Emergency Medicine (Emergency Medicine) Physician	A52709	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1942285507
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CARLA MARIA PEREDO ALCID MD

Provider Business Mailing Address
First Line	:	1201 W LA VETA AVE
Second Line	:
City	:	ORANGE
State	:	CA
Zip	:	92868-4203
Country	:	US
Telephone Number	:	502-541-2637
Fax Number	:	949-748-6664

Provider Business Practice Location Address
First Line	:	1201 W LA VETA AVE
Second Line	:
City	:	ORANGE
State	:	CA
Zip	:	92868-4203
Country	:	US
Telephone Number	:	502-541-2637
Fax Number	:	949-748-6664

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

Provider Enumeration Date	:	12/07/2005
Last Update Date	:	12/05/2013

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Directions to “ CARLA MARIA PEREDO ALCID MD” Practice Location

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