Provider Demographics
NPI:1255658332
Name:UQUILLAS, CARLOS ANDRES (MD)
Entity Type:Individual
Prefix:DR
First Name:CARLOS
Middle Name:ANDRES
Last Name:UQUILLAS
Suffix:
Gender:M
Credentials:MD
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Other - Credentials:
Mailing Address - Street 1:KERLAN - JOBE ORTHOPAEDIC CLINIC
Mailing Address - Street 2:6801 PARK TERRACE , SUITE 500
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90025
Mailing Address - Country:US
Mailing Address - Phone:310-665-7235
Mailing Address - Fax:
Practice Address - Street 1:KERLAN - JOBE ORTHOPAEDIC CLINIC
Practice Address - Street 2:6801 PARK TERRACE , SUITE 500
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90025
Practice Address - Country:US
Practice Address - Phone:310-665-7235
Practice Address - Fax:844-364-1318
Is Sole Proprietor?:No
Enumeration Date:2010-04-28
Last Update Date:2021-02-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
390200000X
CA136243207XX0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program