Provider Demographics
NPI:1285652859
Name:CARRIGG, JOHN WYATT (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:WYATT
Last Name:CARRIGG
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:12 CAMINO ENCINAS
Mailing Address - Street 2:SUITE 14
Mailing Address - City:ORINDA
Mailing Address - State:CA
Mailing Address - Zip Code:94563-3395
Mailing Address - Country:US
Mailing Address - Phone:925-254-6710
Mailing Address - Fax:925-254-6713
Practice Address - Street 1:12 CAMINO ENCINAS
Practice Address - Street 2:SUITE 14
Practice Address - City:ORINDA
Practice Address - State:CA
Practice Address - Zip Code:94563-3395
Practice Address - Country:US
Practice Address - Phone:925-254-6710
Practice Address - Fax:925-254-6713
Is Sole Proprietor?:No
Enumeration Date:2006-07-18
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
CAC032894207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA35098Medicare UPIN