Provider Demographics
NPI:1275885709
Name:PAZ, CARLOS (MD, PHD)
Entity Type:Individual
Prefix:
First Name:CARLOS
Middle Name:
Last Name:PAZ
Suffix:
Gender:M
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7025 N CHESTNUT AVE
Mailing Address - Street 2:STE. 105
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93720-0351
Mailing Address - Country:US
Mailing Address - Phone:559-233-3376
Mailing Address - Fax:559-233-6647
Practice Address - Street 1:7025 N CHESTNUT AVE
Practice Address - Street 2:STE. 105
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93720-0351
Practice Address - Country:US
Practice Address - Phone:559-233-3376
Practice Address - Fax:559-233-6647
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-08
Last Update Date:2015-05-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA 121126207NS0135X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207NS0135XAllopathic & Osteopathic PhysiciansDermatologyProcedural Dermatology