Provider Demographics
NPI:1083928329
Name:MOISES R. CARPIO, M.D., INC.
Entity Type:Organization
Organization Name:MOISES R. CARPIO, M.D., INC.
Other - Org Name:SAFE ICU MEDICAL GROUP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MOISES
Authorized Official - Middle Name:R
Authorized Official - Last Name:CARPIO
Authorized Official - Suffix:
Authorized Official - Credentials:MD, FCCP,CHCQM
Authorized Official - Phone:562-773-4243
Mailing Address - Street 1:2271 W MALVERN AVE
Mailing Address - Street 2:SUITE 359
Mailing Address - City:FULLERTON
Mailing Address - State:CA
Mailing Address - Zip Code:92833-2106
Mailing Address - Country:US
Mailing Address - Phone:562-773-4243
Mailing Address - Fax:714-213-8416
Practice Address - Street 1:2271 W MALVERN AVE
Practice Address - Street 2:SUITE 359
Practice Address - City:FULLERTON
Practice Address - State:CA
Practice Address - Zip Code:92833-2106
Practice Address - Country:US
Practice Address - Phone:562-773-4243
Practice Address - Fax:714-213-8416
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-07-28
Last Update Date:2011-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA33184A174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty