Provider Demographics
NPI:1235109893
Name:CARMEL, JEFFREY ALAN (MD)
Entity Type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:ALAN
Last Name:CARMEL
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:2557 MOWRY AVE
Mailing Address - Street 2:STE 34
Mailing Address - City:FREMONT
Mailing Address - State:CA
Mailing Address - Zip Code:94538
Mailing Address - Country:US
Mailing Address - Phone:510-797-4111
Mailing Address - Fax:510-797-3320
Practice Address - Street 1:2557 MOWRY AVE
Practice Address - Street 2:STE 34
Practice Address - City:FREMONT
Practice Address - State:CA
Practice Address - Zip Code:94538
Practice Address - Country:US
Practice Address - Phone:510-797-4111
Practice Address - Fax:510-797-3320
Is Sole Proprietor?:No
Enumeration Date:2006-01-25
Last Update Date:2007-08-14
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Provider Licenses
StateLicense IDTaxonomies
CAA22891207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
A23289Medicare UPIN