Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2081P2900X | Pain Medicine | 20A8191 | CA |
NPI | 1336110683 |
---|---|
Provider Name | Mr. Claudio M Carvalho |
First Address | Costa Mesa, CA 92627-3824 |
Second Address | Costa Mesa, CA 92627-3824 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/01/2006 |
Last Update Date | 05/06/2013 |