Carl E Primavera
Periodontist
1588 Soquel Dr
Santa Cruz
, California 95065-1714
Carl E Primavera
Periodontist
1588 Soquel Dr
Santa Cruz
, California 95065-1714
(831) 476-4020
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About
Features
Specialties
- Periodontist
Languages spoken
- English
Location
First Address
- Carl E Primavera
- 1588 Soquel Dr
- Santa Cruz, CA
- Zip : 95065-1714
- Phone : (831) 476-4020
Second Address
- Carl E Primavera
- 1588 Soquel Dr
- Santa Cruz, CA
- Zip : 95065-1714
- Phone : (831) 476-4020
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Is Carl E Primavera a sole practitioner?
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 1223P0300X | Periodontist | 21050 | CA |
National Provider Identifier
| NPI | 1053512327 |
|---|---|
| Provider Name | Carl E Primavera |
| First Address | Santa Cruz, CA 95065-1714 |
| Second Address | Santa Cruz, CA 95065-1714 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | Yes |
| Is Organization Subpart | N/A |
| Enumeration Date | 31/05/2007 |
| Last Update Date | 08/07/2007 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 21629043 | EDD ACCOUNT NUMBER (01) | CA |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.