Provider Demographics
NPI:1407909989
Name:CARTER, EUGENE JEROME
Entity Type:Individual
Prefix:
First Name:EUGENE
Middle Name:JEROME
Last Name:CARTER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:EUGENE
Other - Middle Name:JEROME
Other - Last Name:CARTER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:1418 LINDACREST DR
Mailing Address - Street 2:
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90210-2520
Mailing Address - Country:US
Mailing Address - Phone:310-276-5552
Mailing Address - Fax:310-276-5532
Practice Address - Street 1:1418 LINDACREST DR
Practice Address - Street 2:
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90210-2520
Practice Address - Country:US
Practice Address - Phone:310-276-5552
Practice Address - Fax:310-276-5532
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA50430207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine