Provider Demographics
NPI:1275556029
Name:PLATEROTI, CARMELO (DO)
Entity Type:Individual
Prefix:DR
First Name:CARMELO
Middle Name:
Last Name:PLATEROTI
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 1:1101 LAS TABLAS RD
Mailing Address - Street 2:SUITE G
Mailing Address - City:TEMPLETON
Mailing Address - State:CA
Mailing Address - Zip Code:93465-9733
Mailing Address - Country:US
Mailing Address - Phone:805-434-2821
Mailing Address - Fax:805-434-2526
Practice Address - Street 1:1101 LAS TABLAS RD
Practice Address - Street 2:SUITE G
Practice Address - City:TEMPLETON
Practice Address - State:CA
Practice Address - Zip Code:93465-9733
Practice Address - Country:US
Practice Address - Phone:805-434-2821
Practice Address - Fax:805-434-2526
Is Sole Proprietor?:No
Enumeration Date:2006-07-25
Last Update Date:2023-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A6201207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ44336ZOtherBLUE SHIELD
CA20A6201Medicare ID - Type UnspecifiedMEDICARE
CAZZZ44336ZOtherBLUE SHIELD