Provider Demographics
NPI:1346570124
Name:JEFFREY D CARTER MD INC
Entity Type:Organization
Organization Name:JEFFREY D CARTER MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:NICHOLE
Authorized Official - Middle Name:
Authorized Official - Last Name:GUZMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:831-648-8020
Mailing Address - Street 1:21 UPPER RAGSDALE DR
Mailing Address - Street 2:SUITE 100
Mailing Address - City:MONTEREY
Mailing Address - State:CA
Mailing Address - Zip Code:93940-7831
Mailing Address - Country:US
Mailing Address - Phone:831-648-8020
Mailing Address - Fax:831-648-8023
Practice Address - Street 1:21 UPPER RAGSDALE DR
Practice Address - Street 2:SUITE 100
Practice Address - City:MONTEREY
Practice Address - State:CA
Practice Address - Zip Code:93940-7831
Practice Address - Country:US
Practice Address - Phone:831-648-8020
Practice Address - Fax:831-648-8023
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-30
Last Update Date:2010-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA00G525640207XX0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAB74906Medicare UPIN
CA00G525640Medicare PIN