Provider Demographics
NPI:1083052021
Name:GALARRETA AIMA, CAROLINA ISABEL (MD)
Entity Type:Individual
Prefix:DR
First Name:CAROLINA
Middle Name:ISABEL
Last Name:GALARRETA AIMA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:CAROLINA
Other - Middle Name:ISABEL
Other - Last Name:GALARRETA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:9300 VALLEY CHILDRENS PL # SC05
Mailing Address - Street 2:
Mailing Address - City:MADERA
Mailing Address - State:CA
Mailing Address - Zip Code:93636-8762
Mailing Address - Country:US
Mailing Address - Phone:559-353-5700
Mailing Address - Fax:559-353-5708
Practice Address - Street 1:9300 VALLEY CHILDRENS PL # GE21
Practice Address - Street 2:
Practice Address - City:MADERA
Practice Address - State:CA
Practice Address - Zip Code:93636-8762
Practice Address - Country:US
Practice Address - Phone:559-353-6400
Practice Address - Fax:559-353-7213
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-12
Last Update Date:2020-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLTRN18587390200000X
CAA143594207SG0201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207SG0201XAllopathic & Osteopathic PhysiciansMedical GeneticsClinical Genetics (M.D.)Group - Multi-Specialty
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training ProgramGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1083052021Medicaid