Provider Demographics
NPI:1093785487
Name:OBREGON, CARLOS A (DO)
Entity Type:Individual
Prefix:DR
First Name:CARLOS
Middle Name:A
Last Name:OBREGON
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100A KINGS WAY W # A
Mailing Address - Street 2:
Mailing Address - City:SEWELL
Mailing Address - State:NJ
Mailing Address - Zip Code:08080-2235
Mailing Address - Country:US
Mailing Address - Phone:856-218-8080
Mailing Address - Fax:856-218-8070
Practice Address - Street 1:100A KINGS WAY WEST
Practice Address - Street 2:
Practice Address - City:SEWELL
Practice Address - State:NJ
Practice Address - Zip Code:08080
Practice Address - Country:US
Practice Address - Phone:856-218-8080
Practice Address - Fax:856-218-8070
Is Sole Proprietor?:No
Enumeration Date:2006-01-26
Last Update Date:2009-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMB58607207RP1001X, 207RC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ7036507Medicaid
NJ869971Medicare ID - Type Unspecified
NJG28257Medicare UPIN