Provider Demographics
NPI:1205044492
Name:FRANCO, CARLOS (PA)
Entity Type:Individual
Prefix:MR
First Name:CARLOS
Middle Name:
Last Name:FRANCO
Suffix:
Gender:M
Credentials:PA
Other - Prefix:MR
Other - First Name:CARLOS
Other - Middle Name:
Other - Last Name:FRANCO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PA
Mailing Address - Street 1:19082 E COUNTRY HOLW
Mailing Address - Street 2:
Mailing Address - City:ORANGE
Mailing Address - State:CA
Mailing Address - Zip Code:92869-3154
Mailing Address - Country:US
Mailing Address - Phone:714-269-0705
Mailing Address - Fax:714-639-3708
Practice Address - Street 1:661 W 1ST ST STE G
Practice Address - Street 2:
Practice Address - City:TUSTIN
Practice Address - State:CA
Practice Address - Zip Code:92780-2939
Practice Address - Country:US
Practice Address - Phone:714-665-9890
Practice Address - Fax:714-665-9891
Is Sole Proprietor?:No
Enumeration Date:2007-05-19
Last Update Date:2023-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPA13962363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant